Healthcare Provider Details

I. General information

NPI: 1013775410
Provider Name (Legal Business Name): GABRIELLA MADSEN MSN, RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 TONGASS AVE
KETCHIKAN AK
99901-5746
US

IV. Provider business mailing address

1800 CRAIG KLAWOCK HWY
CRAIG AK
99921-0678
US

V. Phone/Fax

Practice location:
  • Phone: 907-228-8300
  • Fax: 907-228-8440
Mailing address:
  • Phone: 907-826-3257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226773
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226774
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: