Provider Demographics
NPI:1811187396
Name:SUTTON, GAYLE A (ARNP NP-C)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:A
Last Name:SUTTON
Suffix:
Gender:F
Credentials:ARNP NP-C
Other - Prefix:MS
Other - First Name:GAYLE
Other - Middle Name:A
Other - Last Name:BERGERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 MILL POND RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6139
Mailing Address - Country:US
Mailing Address - Phone:603-498-4142
Mailing Address - Fax:
Practice Address - Street 1:24 MILL POND RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NH
Practice Address - Zip Code:03833-6139
Practice Address - Country:US
Practice Address - Phone:603-498-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2015-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH055431-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30346071Medicaid