Provider Demographics
NPI:1225693450
Name:PIERCE, GABRIELLA ELISABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLA
Middle Name:ELISABETH
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GABRIELLE
Other - Middle Name:ELISABETH
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4913 W RENO AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-6339
Mailing Address - Country:US
Mailing Address - Phone:405-948-4900
Mailing Address - Fax:405-948-4933
Practice Address - Street 1:5208 W RENO AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-6344
Practice Address - Country:US
Practice Address - Phone:405-948-4900
Practice Address - Fax:405-948-4933
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK39490208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program