Provider Demographics
NPI:1689012098
Name:GAY, BARBARA L (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:GAY
Suffix:
Gender:F
Credentials:RN
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 7
Mailing Address - Street 2:
Mailing Address - City:RAINIER
Mailing Address - State:WA
Mailing Address - Zip Code:98576-0007
Mailing Address - Country:US
Mailing Address - Phone:360-446-0688
Mailing Address - Fax:
Practice Address - Street 1:12942 WAAGONWHEEL LN
Practice Address - Street 2:
Practice Address - City:RAINIER
Practice Address - State:WA
Practice Address - Zip Code:98576-9636
Practice Address - Country:US
Practice Address - Phone:360-446-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00111952163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse