Provider Demographics
NPI:1720769813
Name:VALLIERE-WHITE, GABRIELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:VALLIERE-WHITE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:VALLIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 SOMERSET CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1233 SR-54 W
Practice Address - Street 2:SUITE 120
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:678-272-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN241046207R00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine