Provider Demographics
NPI:1982855698
Name:GASQUE, DOE DENISE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:DOE
Middle Name:DENISE
Last Name:GASQUE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14758 HOPI RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-3536
Mailing Address - Country:US
Mailing Address - Phone:760-486-1492
Mailing Address - Fax:
Practice Address - Street 1:14758 HOPI RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-3536
Practice Address - Country:US
Practice Address - Phone:760-486-1492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR33733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND002401Medicaid
CA556679OtherCALIFORNIA BOARD OF NURSING
NDR33733OtherND NURSING
CA17731OtherCALIFORNIA BOARD OF NURSING