# GABRIELLE GOODRICK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1285686469
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 22811 | AZ | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 10/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0899222 | AETNA | AZ |
| 01 | — | 815204 | HUMANA | AZ |
| 01 | — | 86-0937180 | TAX ID \# | AZ |
| 01 | — | AZ0836190 | BCBS | AZ |