Provider Demographics
NPI:1649357047
Name:DARSEY, GAYLE W (RN, BSN, RNFA)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:W
Last Name:DARSEY
Suffix:
Gender:F
Credentials:RN, BSN, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 2320
Mailing Address - Street 2:
Mailing Address - City:COCHRAN
Mailing Address - State:GA
Mailing Address - Zip Code:31014-9703
Mailing Address - Country:US
Mailing Address - Phone:478-934-4772
Mailing Address - Fax:
Practice Address - Street 1:827 PITTS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-2327
Practice Address - Country:US
Practice Address - Phone:478-986-6825
Practice Address - Fax:478-986-6825
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN047391163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52207252OtherBLUE CROSS/BLUE SHIELD