Provider Demographics
NPI:1841957180
Name:GAYLE, BEVERLY ANN (CRNP)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:GAYLE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:AL
Mailing Address - Zip Code:36783-3137
Mailing Address - Country:US
Mailing Address - Phone:334-627-3497
Mailing Address - Fax:334-627-3501
Practice Address - Street 1:111 MAIN ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:AL
Practice Address - Zip Code:36783-3137
Practice Address - Country:US
Practice Address - Phone:334-627-3497
Practice Address - Fax:334-627-3501
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAG10210145363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care