Active NPI
Gabriel Elijah Killian, RN, BSN
- Registered Nurse
- Rolla, MO
National Provider Identifier
1730064684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2024024076
- Practice address
- 1000 W 10TH St
Rolla, MO 65401-2905 - Phone
- (573) 458-7298
- NPI assigned
- Aug 8, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2024024076 | MO | Primary |
Addresses
Primary practice location
1000 W 10TH St
Rolla, MO 65401-2905
Mailing address
10100 Holt Rd
Newburg, MO 65550-8700
Phone (573) 612-4034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024024076 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754611200000",
"number": "1730064684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10100 HOLT RD",
"city": "NEWBURG",
"state": "MO",
"postal_code": "655508700",
"telephone_number": "573-612-4034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012905",
"telephone_number": "573-458-7298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLIAN",
"first_name": "GABRIEL",
"middle_name": "ELIJAH",
"credential": "RN, BSN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-08",
"last_updated": "2025-08-08",
"certification_date": "2025-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2024024076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.