Provider Demographics
NPI:1619548914
Name:AVILES, GABRIELA (RN)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:AVILES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:
Other - Last Name:AVILES-SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:34 CROYDEN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1709
Mailing Address - Country:US
Mailing Address - Phone:413-364-5148
Mailing Address - Fax:
Practice Address - Street 1:34 CROYDEN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1709
Practice Address - Country:US
Practice Address - Phone:413-364-5148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2325536163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse