Healthcare Provider Details

I. General information

NPI: 1801618871
Provider Name (Legal Business Name): GABRIELLE MIRABELLA CRABTREE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GABRIELLE FAITH MIRABELLA

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL DR
GALAX VA
24333-2227
US

IV. Provider business mailing address

209 THOMAS LN UNIT A
MOUNT AIRY NC
27030-5295
US

V. Phone/Fax

Practice location:
  • Phone: 276-236-8181
  • Fax:
Mailing address:
  • Phone: 423-509-4801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: