Provider Demographics
NPI:1346587573
Name:CONLEY, GAIL DYKHOUSE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:DYKHOUSE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 THIRD STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201
Mailing Address - Country:US
Mailing Address - Phone:478-464-2600
Mailing Address - Fax:478-803-4281
Practice Address - Street 1:610 THIRD STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201
Practice Address - Country:US
Practice Address - Phone:478-464-2600
Practice Address - Fax:478-803-4281
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN121290163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse