Healthcare Provider Details

I. General information

NPI: 1174236327
Provider Name (Legal Business Name): GABRIELLE ELIZABETH DUNFEE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11803 JEFFERSON AVE STE 205
NEWPORT NEWS VA
23606-2565
US

IV. Provider business mailing address

11803 JEFFERSON AVE STE 205
NEWPORT NEWS VA
23606-2565
US

V. Phone/Fax

Practice location:
  • Phone: 757-736-9860
  • Fax:
Mailing address:
  • Phone: 757-736-9860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110009486
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: