Healthcare Provider Details

I. General information

NPI: 1487031530
Provider Name (Legal Business Name): KRISTIN MICHELLE GSELL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 QUINTARD AVE
ANNISTON AL
36201-5711
US

IV. Provider business mailing address

508 WATER OAK CIR
TRUSSVILLE AL
35173-1299
US

V. Phone/Fax

Practice location:
  • Phone: 256-741-9799
  • Fax: 256-741-9795
Mailing address:
  • Phone: 205-478-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN247583
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number1-130700
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN247583
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-130700
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: