Provider Demographics
NPI:1467272047
Name:TRACY, GABRIELLE ROSE (APRN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ROSE
Last Name:TRACY
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1835
Mailing Address - Country:US
Mailing Address - Phone:603-659-3106
Mailing Address - Fax:
Practice Address - Street 1:207 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWMARKET
Practice Address - State:NH
Practice Address - Zip Code:03857-1835
Practice Address - Country:US
Practice Address - Phone:160-329-2729
Practice Address - Fax:603-659-5892
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH082887-21163W00000X
NH082887-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse