Healthcare Provider Details

I. General information

NPI: 1669396578
Provider Name (Legal Business Name): GABRIELLE PERGOLA CEP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 COLLEGE BLVD STE 310
OVERLAND PARK KS
66211-1522
US

IV. Provider business mailing address

6600 COLLEGE BLVD STE 310
OVERLAND PARK KS
66211-1522
US

V. Phone/Fax

Practice location:
  • Phone: 913-346-5688
  • Fax: 855-538-3020
Mailing address:
  • Phone: 913-346-5688
  • Fax: 855-538-3020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: