Provider Demographics
NPI:1013718055
Name:ROMEL (GAETAN), BRIANNA VICTORIA (PA-C)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:VICTORIA
Last Name:ROMEL (GAETAN)
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 ELBA DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-5800
Mailing Address - Country:US
Mailing Address - Phone:570-269-7435
Mailing Address - Fax:
Practice Address - Street 1:218 FOUST ST STE B
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5476
Practice Address - Country:US
Practice Address - Phone:336-626-2793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-15217363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant