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General NPI Number Information
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NPI Number | 1134690555
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Entity Type | Individual
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Provider Name | GABREL MATTHEW CRABB FNP-C
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Gender | Male
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 5248 NEW JESUP HWY
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City | BRUNSWICK
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State | GA
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Zip | 31523-1211
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Country | US
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Telephone | 912-264-1883
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Fax |
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Provider Business Mailing Address
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Address Line | 401 PALM DR
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City | SAINT SIMONS ISLAND
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State | GA
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Zip | 31522-1442
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Country | US
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Telephone | 912-230-6635
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN243885
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License Number State | GA
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