Healthcare Provider Details

I. General information

NPI: 1619840048
Provider Name (Legal Business Name): GABRIELA CAROLINA THOMPSON DNP, AGACNP, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12761 FLAT MEADOW LN
HERNDON VA
20171-2250
US

IV. Provider business mailing address

12761 FLAT MEADOW LN
HERNDON VA
20171-2250
US

V. Phone/Fax

Practice location:
  • Phone: 703-689-9000
  • Fax:
Mailing address:
  • Phone: 703-689-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number00
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: