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General NPI Number Information
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NPI Number | 1114856689
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Entity Type | Individual
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Provider Name | KRISTINA GABRIELSE
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Gender | Female
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Dates
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Enumeration Date | 05/19/2026
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Last Update Date | 05/19/2026
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Provider Practice Location Address
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Address Line | 321 N 2ND ST
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City | CEDAR GROVE
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State | WI
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Zip | 53013-1641
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Country | US
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Telephone | 920-668-8518
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Fax |
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Provider Business Mailing Address
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Address Line | 321 N 2ND ST
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City | CEDAR GROVE
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State | WI
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Zip | 53013-1641
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 190779-30
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License Number State | WI
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