Provider Demographics
NPI:1962082156
Name:VINCENT, GABRIELLE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:VINCENT
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 INDIANOLA AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1344
Mailing Address - Country:US
Mailing Address - Phone:614-519-6302
Mailing Address - Fax:
Practice Address - Street 1:245 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2641
Practice Address - Country:US
Practice Address - Phone:614-224-6617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.003419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty