Healthcare Provider Details

I. General information

NPI: 1073284311
Provider Name (Legal Business Name): GABRIELLE HERMES BURKE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELLE ELIZABETH HERMES NP

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 WAMPANOAG TRL
RIVERSIDE RI
02915
US

IV. Provider business mailing address

DEPT 3010, PO BOX 986524
BOSTON MA
02298-6524
US

V. Phone/Fax

Practice location:
  • Phone: 401-649-4030
  • Fax: 401-649-4031
Mailing address:
  • Phone: 401-443-4992
  • Fax: 401-537-7241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN03061
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN03061
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: