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NPI Code Detail

MEDICARE: MRS. ANN MARIE FRANCES GABRIELSON RN-NP

MEDICARE: MRS. ANN MARIE FRANCES GABRIELSON RN-NP
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
1363LA2200XAdult Health Nurse Practitioner4704178393MI

General Provider Information

NPI Number : 1861825242
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANN MARIE FRANCES GABRIELSON RN-NP
Provider Business Mailing Address
First Line : 3902 MONROE ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48125-2545
Country : US
Telephone Number : 313-562-1985
Fax Number : 313-562-0380
Provider Business Practice Location Address
First Line : 3902 MONROE ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48125-2545
Country : US
Telephone Number : 313-562-1985
Fax Number : 313-562-0380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2013
Last Update Date : 01/23/2017

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