Provider Demographics
NPI:1003869322
Name:NUETZEL, GAIL PATRICIA (CRNP)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:PATRICIA
Last Name:NUETZEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:SUITE 512
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:410-583-0300
Mailing Address - Fax:410-583-0306
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:SUITE 512
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:410-583-0300
Practice Address - Fax:410-583-0306
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR029702363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDN55585OtherCDS LICENSE
MDR029702OtherSTATE LICENSE
MDR029702OtherSTATE LICENSE