=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013775410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GABRIELLA MADSEN MSN, RN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2024
-----------------------------------------------------
Last Update Date | 11/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 TONGASS AVE
-----------------------------------------------------
City | KETCHIKAN
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99901-5746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-228-8300
-----------------------------------------------------
Fax | 907-228-8440
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1800 CRAIG KLAWOCK HWY
-----------------------------------------------------
City | CRAIG
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99921-0678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-826-3257
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 226773
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 226774
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------