Provider Demographics
NPI:1457855421
Name:EARLY, GAYLE (PHD, APRN)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:
Last Name:EARLY
Suffix:
Gender:F
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2243 STONEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-1344
Mailing Address - Country:US
Mailing Address - Phone:424-287-0055
Mailing Address - Fax:
Practice Address - Street 1:1250 BELLFLOWER BLVD SCHOOL OF NURSING
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90840-0001
Practice Address - Country:US
Practice Address - Phone:562-985-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily