Healthcare Provider Details
I. General information
NPI: 1427700491
Provider Name (Legal Business Name): GABRIELLE KATHLEEN RICHARDS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/21/2022
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7342 E THOMAS RD STE 105
SCOTTSDALE AZ
85251-7243
US
IV. Provider business mailing address
PO BOX 6730
CHANDLER AZ
85246-6730
US
V. Phone/Fax
- Phone: 480-821-3600
- Fax: 480-857-2667
- Phone: 480-821-3600
- Fax: 480-857-2667
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | 269192 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 269192 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: