Provider Demographics
NPI:1801860325
Name:SAYLOR, GINA M (ANP)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:M
Last Name:SAYLOR
Suffix:
Gender:F
Credentials:ANP
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 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:1001 HADLEY RD STE LL100
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1883
Practice Address - Country:US
Practice Address - Phone:317-888-1467
Practice Address - Fax:317-888-1476
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28103781A363LA2200X
IN71000144A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200883630Medicaid
IN200883630Medicaid
IN065940NNMedicare PIN