Provider Demographics
NPI:1649164971
Name:GOGA, GABRIELLE (BSN, RN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:GOGA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:WIGNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:414 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:ND
Mailing Address - Zip Code:58730-3106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 4TH ST NE
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:ND
Practice Address - Zip Code:58730-3106
Practice Address - Country:US
Practice Address - Phone:701-580-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant