Malynn Berry Gaboriau, MSN, APRN, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

25884 Issued in SC

Practice address

Taylor at Marion Streets
Columbia, SC 29220-0001

Phone

(803) 296-5709

NPI assigned

Jan 27, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Rose Malynn Berry Gaboriau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1376296756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 PEAK COPPER CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290735901",
            "telephone_number": "803-582-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TAYLOR AT MARION STREETS",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292200001",
            "telephone_number": "803-296-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABORIAU",
        "first_name": "MALYNN",
        "middle_name": "BERRY",
        "credential": "MSN, APRN, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "SC",
            "license": "225895",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "SC",
            "license": "25884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "BERRY GABORIAU",
            "middle_name": "MALYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Columbia, SC
• Neonatal Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.