Provider Demographics
NPI:1619560943
Name:MCINTYRE, GABRIELLE LORIN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:LORIN
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:GABRIELLE
Other - Middle Name:LORIN
Other - Last Name:BECKEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4424A S PRESTWICK RD
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE MDL
Mailing Address - State:NJ
Mailing Address - Zip Code:08641-4123
Mailing Address - Country:US
Mailing Address - Phone:618-980-8127
Mailing Address - Fax:
Practice Address - Street 1:3601 S CONGRESS AVE STE C200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7299
Practice Address - Country:US
Practice Address - Phone:512-537-4087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS79308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily