Provider Demographics
NPI:1538866322
Name:MEEKS, GABRIELLE N (RN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:N
Last Name:MEEKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 HAUSER BLVD # 1-210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3276
Mailing Address - Country:US
Mailing Address - Phone:757-956-7939
Mailing Address - Fax:
Practice Address - Street 1:348 HAUSER BLVD # 1-210
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3276
Practice Address - Country:US
Practice Address - Phone:757-956-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
CA95306933163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide