Provider Demographics
NPI:1396924296
Name:TURNER, GABRIELLE L (PA-C)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:L
Last Name:TURNER
Suffix:
Gender:F
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 1:5 CESSNA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67215-1400
Mailing Address - Country:US
Mailing Address - Phone:316-517-4000
Mailing Address - Fax:316-517-4040
Practice Address - Street 1:5 CESSNA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67215-1400
Practice Address - Country:US
Practice Address - Phone:316-517-4000
Practice Address - Fax:316-517-4040
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00821363A00000X
KS1500821363A00000X
TXPA11616363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1396924296Medicare UPIN