Provider Demographics
NPI:1194000620
Name:GABRIEL, CRISTINA (ANP-BC)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 NEWCASTLE LOOP
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-4502
Mailing Address - Country:US
Mailing Address - Phone:853-215-2400
Mailing Address - Fax:
Practice Address - Street 1:3025 NEWCASTLE LOOP
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-4502
Practice Address - Country:US
Practice Address - Phone:843-215-2400
Practice Address - Fax:843-215-2444
Is Sole Proprietor?:No
Enumeration Date:2011-10-16
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017163363L00000X
CT4840363L00000X
SC23347363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008040380Medicaid