Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 8017 | CT |
NPI | 1003388919 |
---|---|
Provider Name | Mrs. Laura Elizabeth Gabriel |
First Address | New Britain, CT 06053 |
Second Address | New Britain, CT 06053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2018 |
Last Update Date | 28/05/2020 |