Provider Demographics
NPI:1780636266
Name:MOLLERE, GAIL ELIZABETH (NP)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ELIZABETH
Last Name:MOLLERE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13661 PERDIDO KEY DR.
Mailing Address - Street 2:UNIT 902
Mailing Address - City:PERDIDO KEY
Mailing Address - State:FL
Mailing Address - Zip Code:32507
Mailing Address - Country:US
Mailing Address - Phone:850-712-2342
Mailing Address - Fax:
Practice Address - Street 1:312 KENMORE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503
Practice Address - Country:US
Practice Address - Phone:850-471-7525
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 926312363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner