Provider Demographics
NPI:1760478481
Name:PEREIRA, GAYLE E (CRNA)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:E
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:4575 N SHALLOWFORD RD
Mailing Address - Street 2:ATTEN: MARTHA CRAWFORD
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6445
Mailing Address - Country:US
Mailing Address - Phone:770-454-4286
Mailing Address - Fax:770-454-4065
Practice Address - Street 1:4575 N SHALLOWFORD RD
Practice Address - Street 2:ATTEN: MARTHA CRAWFORD
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6445
Practice Address - Country:US
Practice Address - Phone:404-778-8311
Practice Address - Fax:770-454-4065
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2017-03-03
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Provider Licenses
StateLicense IDTaxonomies
GARN061944367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered