Provider Demographics
NPI:1639738727
Name:DEAN, GABRIELLE NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:NICOLE
Last Name:DEAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3188 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2369
Mailing Address - Country:US
Mailing Address - Phone:513-584-4505
Mailing Address - Fax:513-584-0468
Practice Address - Street 1:3188 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2369
Practice Address - Country:US
Practice Address - Phone:513-584-4505
Practice Address - Fax:513-584-0468
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program