Provider Demographics
NPI:1275809634
Name:WEISS, GAIL CORYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:CORYNN
Last Name:WEISS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 FAYETTE ROAD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895
Mailing Address - Country:US
Mailing Address - Phone:301-929-8832
Mailing Address - Fax:
Practice Address - Street 1:3205 FAYETTE RD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895
Practice Address - Country:US
Practice Address - Phone:301-929-8832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR102940163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse