Provider Demographics
NPI:1083787949
Name:HAND, GAYLE ANN (ANP)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:ANN
Last Name:HAND
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3449
Mailing Address - Country:US
Mailing Address - Phone:541-683-4404
Mailing Address - Fax:541-683-4405
Practice Address - Street 1:390 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3449
Practice Address - Country:US
Practice Address - Phone:541-683-4404
Practice Address - Fax:541-683-4405
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200250077NP-PP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORDMAP 100162Medicaid
1083787949OtherNPI
ORDMAP 100162Medicaid
R146492Medicare PIN