Provider Demographics
NPI:1578785416
Name:PERES, GAIL MCDONALD (CNM)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:MCDONALD
Last Name:PERES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3847 E RIVER DR
Mailing Address - Street 2:
Mailing Address - City:FT. MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-1024
Mailing Address - Country:US
Mailing Address - Phone:239-693-5565
Mailing Address - Fax:
Practice Address - Street 1:3847 E RIVER DR
Practice Address - Street 2:
Practice Address - City:FT. MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-1024
Practice Address - Country:US
Practice Address - Phone:239-693-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1625982367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife