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NPI Code Detail

MEDICARE: OLLYNE GABBIDON

MEDICARE: OLLYNE GABBIDON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR184823MD

General Provider Information

NPI Number : 1649140823
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLLYNE GABBIDON
Provider Business Mailing Address
First Line : 42114 BARRYMOORE PL
Second Line :
City : CHANTILLY
State : VA
Zip : 20152-6443
Country : US
Telephone Number : 703-722-4828
Fax Number : 703-791-1183
Provider Business Practice Location Address
First Line : 6710A ROCKLEDGE DR STE 400
Second Line :
City : BETHESDA
State : MD
Zip : 20817-2847
Country : US
Telephone Number : 703-722-4828
Fax Number : 703-791-1183
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2025
Last Update Date : 03/12/2026

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