Provider Demographics
NPI:1083073910
Name:CARDELLE, GAIL ANN
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ANN
Last Name:CARDELLE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:GAIL
Other - Middle Name:ANN
Other - Last Name:DESROSIERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:12 INDIAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-5316
Mailing Address - Country:US
Mailing Address - Phone:508-878-2291
Mailing Address - Fax:
Practice Address - Street 1:12 INDIAN HILL RD
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-5316
Practice Address - Country:US
Practice Address - Phone:508-878-2291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-20
Last Update Date:2016-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN49710164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse