Provider Demographics
NPI:1144079716
Name:THIERET, GABRIELLA (CRNP)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:THIERET
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9713
Mailing Address - Country:US
Mailing Address - Phone:412-589-6032
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE STE 409
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1302
Practice Address - Country:US
Practice Address - Phone:412-578-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily