Provider Demographics
NPI:1013425651
Name:GAYLE, PAULETTE (DOULA)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:GAYLE
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2968 HERITAGE OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7083
Mailing Address - Country:US
Mailing Address - Phone:678-863-3541
Mailing Address - Fax:
Practice Address - Street 1:2968 HERITAGE OAKS CIR
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7083
Practice Address - Country:US
Practice Address - Phone:678-863-3541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ628140374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula