Provider Demographics
NPI:1326580366
Name:HARVEY, GAYLA (RN)
Entity Type:Individual
Prefix:
First Name:GAYLA
Middle Name:
Last Name:HARVEY
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:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:LAPOINT
Mailing Address - State:UT
Mailing Address - Zip Code:84039-0206
Mailing Address - Country:US
Mailing Address - Phone:435-828-3549
Mailing Address - Fax:
Practice Address - Street 1:6822 E 1000 S
Practice Address - Street 2:
Practice Address - City:FT. DUCHENSE
Practice Address - State:UT
Practice Address - Zip Code:84026
Practice Address - Country:US
Practice Address - Phone:435-725-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4777606-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse