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General NPI Number Information
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NPI Number | 1245950153
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Entity Type | Individual
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Provider Name | GABRIEL REED ARCHER PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 115 ROANOKE BLVD # 5004
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City | SALEM
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State | VA
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Zip | 24153-4907
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Country | US
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Telephone | 865-234-2562
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Fax | 833-605-4359
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Provider Business Mailing Address
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Address Line | 115 ROANOKE BLVD # 5004
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City | SALEM
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State | VA
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Zip | 24153-4907
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Country | US
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Telephone | 865-234-2562
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Fax | 833-605-4359
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024195582
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License Number State | VA
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