Provider Demographics
NPI:1992832208
Name:TARLTON, GAIL FRANCIS (MS APRN BC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:FRANCIS
Last Name:TARLTON
Suffix:
Gender:F
Credentials:MS APRN BC
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:ANN
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11637 TERRACE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602
Mailing Address - Country:US
Mailing Address - Phone:301-870-7287
Mailing Address - Fax:301-870-0687
Practice Address - Street 1:11637 TERRACE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:301-870-7287
Practice Address - Fax:301-870-0687
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR139252363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1160352OtherDEA
MD141733ZAWGMedicare PIN