Provider Demographics
NPI:1801082581
Name:ALLEN, GAIL P (APRN)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:P
Last Name:ALLEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 409
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30747-0409
Mailing Address - Country:US
Mailing Address - Phone:706-857-5402
Mailing Address - Fax:706-857-1800
Practice Address - Street 1:68 STOCKADE RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:GA
Practice Address - Zip Code:30747-1900
Practice Address - Country:US
Practice Address - Phone:706-857-5402
Practice Address - Fax:706-857-1800
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN021267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily