Provider Demographics
NPI:1871300608
Name:GRAU APA, GABRIELA (APRN)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:GRAU APA
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 1:3828 BARDSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1527
Mailing Address - Country:US
Mailing Address - Phone:502-479-8930
Mailing Address - Fax:502-385-6541
Practice Address - Street 1:3828 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1527
Practice Address - Country:US
Practice Address - Phone:502-479-8930
Practice Address - Fax:502-385-6541
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4023253363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7101028890Medicaid