Provider Demographics
NPI:1295476455
Name:YATES, GABRIELLE ELIZABETH (APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ELIZABETH
Last Name:YATES
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
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Mailing Address - Street 1:3410 INDIAN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-6627
Mailing Address - Country:US
Mailing Address - Phone:321-432-9201
Mailing Address - Fax:
Practice Address - Street 1:1400 W STATE ROAD 434 STE 1010
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-3817
Practice Address - Country:US
Practice Address - Phone:407-644-9970
Practice Address - Fax:407-644-6926
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-04
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029491363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics