Hannibal Gerhson Avecilla, MSN, RN, CNOR, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15503 Issued in CA

Practice address

1200 E California Ave
Unit H
Glendale, CA 91206-3852

Phone

(818) 547-9564

NPI assigned

Sep 30, 2008

Last updated

Oct 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1528218211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E CALIFORNIA AVE",
            "address_2": "UNIT H",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063852",
            "telephone_number": "818-547-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E CALIFORNIA AVE",
            "address_2": "UNIT H",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063852",
            "telephone_number": "818-547-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVECILLA",
        "first_name": "HANNIBAL",
        "middle_name": "GERHSON",
        "name_prefix": "Mr.",
        "credential": "MSN, RN, CNOR, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.