Provider Demographics
NPI:1013775410
Name:MADSEN, GABRIELLA (MSN, RN, FNP-C)
Entity type:Individual
Prefix:MISS
First Name:GABRIELLA
Middle Name:
Last Name:MADSEN
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 CRAIG KLAWOCK HWY
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:AK
Mailing Address - Zip Code:99921-0678
Mailing Address - Country:US
Mailing Address - Phone:907-826-3257
Mailing Address - Fax:
Practice Address - Street 1:3100 TONGASS AVE
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5746
Practice Address - Country:US
Practice Address - Phone:907-228-8300
Practice Address - Fax:907-228-8440
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK226773363LF0000X, 363LF0000X
AK226774163W00000X
WI1515730363LF0000X
IL041.533430163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine