Provider Demographics
NPI:1780662668
Name:FRIEDT, GAIL LAURIE (RN)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:LAURIE
Last Name:FRIEDT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:LAURIE
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3214 AZAHAR PL
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8302
Mailing Address - Country:US
Mailing Address - Phone:760-500-1275
Mailing Address - Fax:
Practice Address - Street 1:3214 AZAHAR PL
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8302
Practice Address - Country:US
Practice Address - Phone:760-500-1275
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN406303163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine