Provider Demographics
NPI:1861287542
Name:WILSON, GABRIELLE GENICE (CNA)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:GENICE
Last Name:WILSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8827 39TH STREET CIR E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2211
Mailing Address - Country:US
Mailing Address - Phone:727-902-6339
Mailing Address - Fax:
Practice Address - Street 1:8827 39TH STREET CIR E
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-2211
Practice Address - Country:US
Practice Address - Phone:727-902-6339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 376J00000X
FLCNA456409376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker