Healthcare Provider Details

I. General information

NPI: 1194518829
Provider Name (Legal Business Name): GABRIELLE AQUILLA KUHN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELLE AQUILLA WADDELL

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 KERNERSVILLE MEDICAL PKWY STE 210
KERNERSVILLE NC
27284-7198
US

IV. Provider business mailing address

PO BOX 935983
ATLANTA GA
31193-5983
US

V. Phone/Fax

Practice location:
  • Phone: 336-515-7440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5022231
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: