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General NPI Number Information
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NPI Number | 1316602832
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Entity Type | Individual
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Provider Name | GABRIELLE ROSE NESSELRODE FNP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 5316 W COUNTRY GARDEN LN
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City | LAVEEN
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State | AZ
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Zip | 85339-4520
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Country | US
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Telephone | 724-496-8229
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Fax |
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Provider Business Mailing Address
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Address Line | 4690 E LAVENDER LN
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City | PHOENIX
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State | AZ
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Zip | 85044-4824
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Country | US
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Telephone | 724-496-8229
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RNP262130
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F04210426
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License Number State | PA
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