Provider Demographics
NPI:1679598551
Name:MCGLOTHLEN, GAIL L (RN-C, MS)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:L
Last Name:MCGLOTHLEN
Suffix:
Gender:F
Credentials:RN-C, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5510
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94581-0510
Mailing Address - Country:US
Mailing Address - Phone:707-252-9666
Mailing Address - Fax:
Practice Address - Street 1:3434 VILLA LN
Practice Address - Street 2:SUITE 150
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6405
Practice Address - Country:US
Practice Address - Phone:707-252-9666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN296101 CNS1534364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21311ZMedicare ID - Type Unspecified
CAP37935Medicare UPIN