MEDICARE: GABRIELLA CHASE WILLIAMS ARNP

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
1	363LG0600X	Gerontology Nurse Practitioner	RN328320	GA

General Provider Information

NPI Number	:	1952130635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLA CHASE WILLIAMS ARNP

Provider Business Mailing Address
First Line	:	1132 CHANDLER HAULK RD
Second Line	:
City	:	LOGANVILLE
State	:	GA
Zip	:	30052-3104
Country	:	US
Telephone Number	:	347-616-1938
Fax Number	:

Provider Business Practice Location Address
First Line	:	4580 MEMORIAL DR
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30032-1447
Country	:	US
Telephone Number	:	404-963-6861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2024
Last Update Date	:	07/30/2024

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