Provider Demographics
NPI:1235324633
Name:ELY, GAY D (NP)
Entity Type:Individual
Prefix:MS
First Name:GAY
Middle Name:D
Last Name:ELY
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Gender:F
Credentials:NP
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8086
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-6693
Mailing Address - Fax:314-362-6660
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-6693
Practice Address - Fax:314-362-6660
Is Sole Proprietor?:No
Enumeration Date:2007-09-09
Last Update Date:2016-07-19
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Provider Licenses
StateLicense IDTaxonomies
MO0100180363L00000X
MO100180363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner