Provider Demographics
NPI:1821752072
Name:CAPORASO, GABRIELLE KEANA (RN)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:KEANA
Last Name:CAPORASO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:KEANA
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8200 HAVEN AVE APT 8307
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6975
Mailing Address - Country:US
Mailing Address - Phone:760-953-0670
Mailing Address - Fax:
Practice Address - Street 1:30 HUNTER LN
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2400
Practice Address - Country:US
Practice Address - Phone:800-748-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95236691163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse