Healthcare Provider Details

I. General information

NPI: 1043136609
Provider Name (Legal Business Name): GABRIELLE VANDERPOEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 KNOLLWOOD WAY
HIGHLANDS RANCH CO
80126-3060
US

IV. Provider business mailing address

1306 KNOLLWOOD WAY
HIGHLANDS RANCH CO
80126-3060
US

V. Phone/Fax

Practice location:
  • Phone: 983-204-0316
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-323036
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: