Provider Demographics
NPI:1003210980
Name:GAYLES, DAISY
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:GAYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 WISCONSIN AVE N.W.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-289-1201
Mailing Address - Fax:202-289-5461
Practice Address - Street 1:1010 WISCONSIN AVE NW. SUITE 300
Practice Address - Street 2:PROFESSIONAL HEALTHCARE RESOURCES
Practice Address - City:WASHINTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-289-1201
Practice Address - Fax:202-289-5461
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide