Provider Demographics
NPI:1467979948
Name:SNELL, GAIL LAWRENCE (MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:LAWRENCE
Last Name:SNELL
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 REAGAN CIR NW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-4201
Mailing Address - Country:US
Mailing Address - Phone:404-310-6324
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE STREET
Practice Address - Street 2:MOT, 4TH FLOOR, CENTER FOR HEART FAILURE THERAPY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308
Practice Address - Country:US
Practice Address - Phone:404-686-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN121218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GANONEMedicaid