Provider Demographics
NPI:1073878039
Name:ENFIELD, GABRIELLE (MPA)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:ENFIELD
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11565 LONE DESERT DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-5566
Mailing Address - Country:US
Mailing Address - Phone:775-972-9318
Mailing Address - Fax:
Practice Address - Street 1:11565 LONE DESERT DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-5566
Practice Address - Country:US
Practice Address - Phone:775-972-9318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker