Provider Demographics
NPI:1386144848
Name:STEVENS, GABRIELLE NICOLE (CNP)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:NICOLE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 JOHNSON FERRY RD STE 900
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4768
Mailing Address - Country:US
Mailing Address - Phone:404-459-1900
Mailing Address - Fax:
Practice Address - Street 1:980 JOHNSON FERRY RD STE 900
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4768
Practice Address - Country:US
Practice Address - Phone:404-459-1900
Practice Address - Fax:404-459-1903
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN213701363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health