Provider Demographics
NPI:1154416121
Name:HILBURN, GAYLE C (CRNA)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:C
Last Name:HILBURN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:C
Other - Last Name:HANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1216 ABERDEEN CT S
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3303
Mailing Address - Country:US
Mailing Address - Phone:251-342-7106
Mailing Address - Fax:
Practice Address - Street 1:2451 FILLINGIM ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2238
Practice Address - Country:US
Practice Address - Phone:251-471-7035
Practice Address - Fax:251-471-7042
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1045445367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered