Provider Demographics
NPI:1255912762
Name:EISEL, GABRIELLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:
Last Name:EISEL
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 1:9190 SPRINGFIELD RD APT 19C
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3198
Mailing Address - Country:US
Mailing Address - Phone:234-567-1698
Mailing Address - Fax:
Practice Address - Street 1:9190 SPRINGFIELD RD APT 19C
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3198
Practice Address - Country:US
Practice Address - Phone:234-567-1698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030945363L00000X
OHRN.466439163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner