Provider Demographics
NPI:1497852719
Name:STEVENS, GAIL ANN (CRNP-F)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ANN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:CRNP-F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5613
Mailing Address - Country:US
Mailing Address - Phone:410-860-0611
Mailing Address - Fax:
Practice Address - Street 1:WICOMICO MIDDLE SCHOOL WELLNESS CENTER,WICOMICO COUNTY
Practice Address - Street 2:108 EAST MAIN STREET
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-219-2842
Practice Address - Fax:410-341-7968
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO51367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
472278OtherVALUE OPIONS
PK1000067101OtherAPS
DC0011OtherDCB/S
472278OtherVALUE OPIONS