Provider Demographics
NPI:1073399341
Name:TOPAL, GINA MARIE (RN-BSN)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:TOPAL
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:SANTAGATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6800 STATE ROUTE 162
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-8521
Mailing Address - Country:US
Mailing Address - Phone:618-391-5597
Mailing Address - Fax:
Practice Address - Street 1:6800 STATE ROUTE 162
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-8521
Practice Address - Country:US
Practice Address - Phone:618-391-5597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041364125163W00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse