Individual provider Active NPI

Gabrielle Nicolle

  • Family Nurse Practitioner
  • Monroe, LA
National Provider Identifier
1578826772
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06880 Issued in LA
Practice address
3402 Magnolia CV
Monroe, LA 71203-2374
Phone
(318) 388-5830
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06880 LA Primary

Addresses

Primary practice location

3402 Magnolia CV
Monroe, LA 71203-2374

Mailing address

6081 Ravine Rd
Bastrop, LA 71220-7839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322002538 LA Practitioner - Nurse Practitioner 0941507776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Arthritis and Diabetes Clinic IncGroup PAC ID 7012981368, 5 clinicians

Practice addresses (Care Compare)

3402 Magnolia Cove
Monroe, LA 71203-2374

3402 Magnolia CV
Monroe, LA 71203-2374
Phone (318) 388-5830

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP06880LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Arthritis and Diabetes Clinic Inc CurrentSince Feb 3, 2016 Accepting new patients

Locations

3402 Magnolia Cv
Monroe, LA 71203
Phone (318) 388-5380

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1578826772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6081 RAVINE RD",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712207839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 MAGNOLIA CV",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032374",
            "telephone_number": "318-388-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLLE",
        "first_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.