Provider Demographics
NPI:1942295332
Name:FRAHM, GAIL M (APRN)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:M
Last Name:FRAHM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LIBERTY SQ
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-2637
Mailing Address - Country:US
Mailing Address - Phone:860-229-9688
Mailing Address - Fax:860-229-5498
Practice Address - Street 1:1 LIBERTY SQ
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-2637
Practice Address - Country:US
Practice Address - Phone:860-229-9688
Practice Address - Fax:860-229-5498
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT400002490CT01OtherANTHEM BC
CT020490OtherCONNECTICARE
CTP29212Medicare UPIN
CT500000618Medicare ID - Type Unspecified