Provider Demographics
NPI:1619738457
Name:PACHECO, GABRIELA (FNP-C)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 EASTLAND LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76305-7283
Mailing Address - Country:US
Mailing Address - Phone:918-850-8356
Mailing Address - Fax:
Practice Address - Street 1:215 WESTSIDE DR STE 200
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3869
Practice Address - Country:US
Practice Address - Phone:940-273-5700
Practice Address - Fax:940-273-5699
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1150312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily