Provider Demographics
NPI:1770512279
Name:AMMONS, GAIL JOAN (CRNP)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:JOAN
Last Name:AMMONS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-5736
Mailing Address - Fax:717-851-6162
Practice Address - Street 1:300 PINE GROVE COMMONS
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5176
Practice Address - Country:US
Practice Address - Phone:717-851-5736
Practice Address - Fax:717-851-6162
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP000331363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1551673OtherGATEWAY-WMG
PA20019274OtherAMERIHEALTH MERCY-WMG
MD618278OtherCAREFIRST MD BCBS
PA50000129OtherCAPITAL BLUE CROSS
PA039286OtherJOHNS HOPKINS
PAS47975Medicare UPIN
PA1551673OtherGATEWAY-WMG
MD618278OtherCAREFIRST MD BCBS