Provider Demographics
NPI:1083690234
Name:COVINGTON, GAIL L (FNP-C)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:L
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:HATTERAS
Mailing Address - State:NC
Mailing Address - Zip Code:27943-0400
Mailing Address - Country:US
Mailing Address - Phone:252-986-2756
Mailing Address - Fax:252-986-0126
Practice Address - Street 1:57635 N. HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:HATTARAS
Practice Address - State:NC
Practice Address - Zip Code:27943-0400
Practice Address - Country:US
Practice Address - Phone:252-986-2756
Practice Address - Fax:252-986-0126
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200636207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCR40812Medicare UPIN
NC2592792DMedicare PIN
NC2592792CMedicare ID - Type Unspecified