Provider Demographics
NPI:1962532937
Name:DAMASCO, GABRIELLE P (MSN, CRNP)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:P
Last Name:DAMASCO
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:915 OLD FERN HILL RD
Mailing Address - Street 2:BLDG A, STE 5
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4269
Mailing Address - Country:US
Mailing Address - Phone:610-696-2850
Mailing Address - Fax:610-696-2579
Practice Address - Street 1:915 OLD FERN HILL RD
Practice Address - Street 2:BLDG A, STE 5
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4269
Practice Address - Country:US
Practice Address - Phone:610-696-2850
Practice Address - Fax:610-696-2579
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004647M363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA023835GT6Medicare PIN