Provider Demographics
NPI:1548729650
Name:SHARP, GABRIELLE ELIZABETH (DC)
Entity type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:ELIZABETH
Last Name:SHARP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 COURT STREET P.O. BOX 32
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:52361
Mailing Address - Country:US
Mailing Address - Phone:319-668-8196
Mailing Address - Fax:319-668-1054
Practice Address - Street 1:513 COURT STREET
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:IA
Practice Address - Zip Code:52361
Practice Address - Country:US
Practice Address - Phone:319-668-8196
Practice Address - Fax:319-668-1054
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor