Provider Demographics
NPI:1922361872
Name:GAY, NATHANIEL LAYNE (DNP, FNP, GNP)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:LAYNE
Last Name:GAY
Suffix:
Gender:M
Credentials:DNP, FNP, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 S 8400 W
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-4907
Mailing Address - Country:US
Mailing Address - Phone:801-250-9638
Mailing Address - Fax:
Practice Address - Street 1:3665 S 8400 W
Practice Address - Street 2:SUITE 110
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-4907
Practice Address - Country:US
Practice Address - Phone:801-250-9638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6229844-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily