Provider Demographics
NPI:1114544749
Name:CAVALHEIRO, GISELE FERNANDES (NP-C)
Entity type:Individual
Prefix:
First Name:GISELE
Middle Name:FERNANDES
Last Name:CAVALHEIRO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10320 VIRGINIA PINE LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5810
Mailing Address - Country:US
Mailing Address - Phone:404-202-9265
Mailing Address - Fax:
Practice Address - Street 1:10320 VIRGINIA PINE LN
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-5810
Practice Address - Country:US
Practice Address - Phone:404-202-9265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN271331363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily