Gabrielle Durbin
Individual provider Active NPI Private Vehicle · Rathdrum, ID
NPI 1770768624 · NPPES record last updated Jan 9, 2008
Key facts
- NPI
- 1770768624
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- License
- GT203134G (ID)
- Practice address
- W 7164 Diagonal
Rathdrum, ID 83858-0283 - Phone
- (208) 755-2368
- NPI assigned
- Jan 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GT203134G | ID | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | GT203134G | ID | Yes |
Addresses
Primary practice location
W 7164 Diagonal
Rathdrum, ID 83858-0283
Mailing address
PO Box 283
Rathdrum, ID 83858-0283
Phone (208) 755-2368
Other providers in Rathdrum, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.