Provider Demographics
NPI:1114167418
Name:DOLSON, GAIL H (RN, MS, ANP)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:H
Last Name:DOLSON
Suffix:
Gender:F
Credentials:RN, MS, ANP
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:H
Other - Last Name:DOLSON-FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MS, ANP
Mailing Address - Street 1:2813 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-4643
Mailing Address - Country:US
Mailing Address - Phone:510-351-4587
Mailing Address - Fax:510-351-4587
Practice Address - Street 1:2813 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-4643
Practice Address - Country:US
Practice Address - Phone:510-351-4587
Practice Address - Fax:510-351-4587
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 184893163W00000X, 363LA2200X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health