Healthcare Provider Details

I. General information

NPI: 1235042904
Provider Name (Legal Business Name): GABRIELLE BREHMEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 S 700 E
MILLCREEK UT
84107-2177
US

IV. Provider business mailing address

3816 E NICOLE AVE
KINGMAN AZ
86409-0834
US

V. Phone/Fax

Practice location:
  • Phone: 801-274-3280
  • Fax:
Mailing address:
  • Phone: 541-531-2091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: