Provider Demographics
NPI:1669277448
Name:MAHOOD, GAYLE MARIE (EMT)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:MARIE
Last Name:MAHOOD
Suffix:
Gender:
Credentials:EMT
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:MARIE
Other - Last Name:THIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:PAGE
Mailing Address - State:NE
Mailing Address - Zip Code:68766-0035
Mailing Address - Country:US
Mailing Address - Phone:240-818-3326
Mailing Address - Fax:
Practice Address - Street 1:106 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PAGE
Practice Address - State:NE
Practice Address - Zip Code:68766-5018
Practice Address - Country:US
Practice Address - Phone:402-338-5901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15362207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services