Provider Demographics
NPI:1164551214
Name:PEARSON, GAIL (NP)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 420
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2780
Mailing Address - Country:US
Mailing Address - Phone:303-788-8888
Mailing Address - Fax:303-788-6452
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:SUITE 420
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2780
Practice Address - Country:US
Practice Address - Phone:303-788-8888
Practice Address - Fax:303-788-6452
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO70838363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60887010Medicaid
CO60887010Medicaid
COQ40236Medicare UPIN