Provider Demographics
NPI:1639863418
Name:MITCHELL, GABRIELLE ALEXANDRIA (APRN)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ALEXANDRIA
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3372 SW 175TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1698
Mailing Address - Country:US
Mailing Address - Phone:954-445-4363
Mailing Address - Fax:
Practice Address - Street 1:3372 SW 175TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-1698
Practice Address - Country:US
Practice Address - Phone:954-445-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023924363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care