Individual
GABRIELLE GIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 SAINT ANN DR STE B, MANDEVILLE, LA 70471-3472
(985) 626-1717
Mailing address
1202 S TYLER ST, COVINGTON, LA 70433-2330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
323916
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
323916
LICENSE
LA
Enumeration date
03/30/2017
Last updated
08/28/2020
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