Provider Demographics
NPI:1629099668
Name:FASO, GAIL ZEMZICKI (RN, MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ZEMZICKI
Last Name:FASO
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:4424 GOLD NUGGET CT
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-9766
Mailing Address - Country:US
Mailing Address - Phone:209-543-7937
Mailing Address - Fax:
Practice Address - Street 1:1524 MCHENRY AVE STE 315 ROOM 37
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4566
Practice Address - Country:US
Practice Address - Phone:209-557-6200
Practice Address - Fax:209-557-6235
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily