Provider Demographics
NPI:1205845534
Name:SHUE, GAIL (CRNA)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:SHUE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1439 GLENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-4937
Mailing Address - Country:US
Mailing Address - Phone:352-650-9087
Mailing Address - Fax:
Practice Address - Street 1:15205 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6072
Practice Address - Country:US
Practice Address - Phone:352-597-7744
Practice Address - Fax:352-597-7797
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2609922367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070887900Medicaid
FLP00305284OtherRR MEDICARE