Provider Demographics
NPI:1710425194
Name:SWEENEY, GABRIELLE NOELLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:NOELLE
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 DANIELS ST
Mailing Address - Street 2:
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054-1281
Mailing Address - Country:US
Mailing Address - Phone:860-324-7113
Mailing Address - Fax:
Practice Address - Street 1:27 DANIELS ST
Practice Address - Street 2:
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054-1281
Practice Address - Country:US
Practice Address - Phone:860-324-7113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266921163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics