Provider Demographics
NPI:1861019416
Name:BACHELIER, GAYLE CECILIA
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:CECILIA
Last Name:BACHELIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 N CENTRAL AVE UNIT 303
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1373
Mailing Address - Country:US
Mailing Address - Phone:571-641-0147
Mailing Address - Fax:
Practice Address - Street 1:2302 N CENTRAL AVE UNIT 303
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1373
Practice Address - Country:US
Practice Address - Phone:571-641-0147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ243266363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health