Provider Demographics
NPI:1962390294
Name:GABRIELSON, KIMBERLEE THERESE (DNP, FNP)
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:THERESE
Last Name:GABRIELSON
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:KIMBERLEE
Other - Middle Name:THERESE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5719 TEXAS DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-8979
Mailing Address - Country:US
Mailing Address - Phone:269-366-9605
Mailing Address - Fax:
Practice Address - Street 1:117 W PATERSON ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-2581
Practice Address - Country:US
Practice Address - Phone:269-349-2641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704322987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily