Gabrielle Broadnax

Individual provider Active NPI Registered Nurse · Stamford, CT

NPI 1205450673 · NPPES record last updated Sep 3, 2026

Key facts

NPI
1205450673
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
804373 (NY)
Practice address
154 Cold Spring Rd Apt 52
Stamford, CT 06905-4215
Phone
(706) 604-9093
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
336776NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 804373 NY Yes
Registered Nurse 163W00000X 193627 CT

Addresses

Primary practice location

154 Cold Spring Rd Apt 52
Stamford, CT 06905-4215

Mailing address

154 Cold Spring Rd Apt 52
Stamford, CT 06905-4215

Other providers in Stamford, CT

All providers in Stamford, CT · Registered Nurse in Connecticut

Sources for this page

Verify at the official NPI Registry.