Provider Demographics
NPI:1225696388
Name:GULLETT, PAIGE
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:
Last Name:GULLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 BETHESDA DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-0815
Mailing Address - Country:US
Mailing Address - Phone:740-569-5737
Mailing Address - Fax:740-569-5716
Practice Address - Street 1:930 BETHESDA DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0815
Practice Address - Country:US
Practice Address - Phone:740-569-5737
Practice Address - Fax:740-569-5716
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator