Provider Demographics
NPI:1497548440
Name:REGISTER, GABRIELLE (PA)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:REGISTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:JETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1420 NW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-5074
Mailing Address - Country:US
Mailing Address - Phone:352-222-0634
Mailing Address - Fax:
Practice Address - Street 1:1505 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1134
Practice Address - Country:US
Practice Address - Phone:352-733-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant