Provider Demographics
NPI:1346632627
Name:BROOKSHIRE, GABRIELLA ROSE (CNIM)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:ROSE
Last Name:BROOKSHIRE
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1945
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901-1945
Mailing Address - Country:US
Mailing Address - Phone:719-888-1007
Mailing Address - Fax:719-487-2689
Practice Address - Street 1:7216 PADDLEWHEEL CT
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-7718
Practice Address - Country:US
Practice Address - Phone:210-275-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic