Individual
GABRIELLE FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 KETTLE POINT AVE, EAST PROVIDENCE, RI 02914-5375
(401) 457-1500
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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