Provider Demographics
NPI:1952991333
Name:GUNTER, GABRIELLA MARIE (CPM)
Entity type:Individual
Prefix:MISS
First Name:GABRIELLA
Middle Name:MARIE
Last Name:GUNTER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:CASON
Mailing Address - State:TX
Mailing Address - Zip Code:75636-0384
Mailing Address - Country:US
Mailing Address - Phone:938-853-0967
Mailing Address - Fax:
Practice Address - Street 1:505 N 2ND ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-6439
Practice Address - Country:US
Practice Address - Phone:903-392-0230
Practice Address - Fax:833-790-2495
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20120022176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife