Provider Demographics
NPI:1770922791
Name:GONZALES, GAIL ANN
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ANN
Last Name:GONZALES
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:GAIL
Other - Middle Name:ANN
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:51 HARLOW ST
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1813
Mailing Address - Country:US
Mailing Address - Phone:207-989-5141
Mailing Address - Fax:
Practice Address - Street 1:51 HARLOW ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1813
Practice Address - Country:US
Practice Address - Phone:207-989-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant