Provider Demographics
NPI:1184270324
Name:KHALIL EBEID, GAIL (RN)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:KHALIL EBEID
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 N HAYDEN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6649
Mailing Address - Country:US
Mailing Address - Phone:317-622-6949
Mailing Address - Fax:
Practice Address - Street 1:3260 N HAYDEN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6649
Practice Address - Country:US
Practice Address - Phone:317-622-6949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health