Provider Demographics
NPI:1114735297
Name:CISNEROS, GABRIELLE (CD, RN BSN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:CD, RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DOUGLAS WOOD LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-6292
Mailing Address - Country:US
Mailing Address - Phone:865-924-3154
Mailing Address - Fax:
Practice Address - Street 1:1600 DOUGLAS WOOD LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-6292
Practice Address - Country:US
Practice Address - Phone:865-924-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula