Provider Demographics
NPI:1467092924
Name:FIELSTRA, GABRIELLE MAE (DVM)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:MAE
Last Name:FIELSTRA
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 S 77TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-7817
Mailing Address - Country:US
Mailing Address - Phone:918-892-9382
Mailing Address - Fax:
Practice Address - Street 1:1711 S 77TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-7817
Practice Address - Country:US
Practice Address - Phone:918-892-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4804174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist