Provider Demographics
NPI:1932387842
Name:NEAL-BARNEY, GABRIELLE LOGAN (MMS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:LOGAN
Last Name:NEAL-BARNEY
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5027 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7046
Mailing Address - Country:US
Mailing Address - Phone:910-599-5143
Mailing Address - Fax:910-442-8770
Practice Address - Street 1:5027 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7046
Practice Address - Country:US
Practice Address - Phone:888-815-5502
Practice Address - Fax:910-442-8770
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01444363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-01444OtherNORTH CAROLINA MEDICAL LICENSE NUMBER
NCMN1816620OtherDEA REGISTRATION