Provider Demographics
NPI:1982813077
Name:ESTES, GAYLA R (CRNA)
Entity Type:Individual
Prefix:
First Name:GAYLA
Middle Name:R
Last Name:ESTES
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:680 RD 1310
Mailing Address - City:MOOREVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38857-0057
Mailing Address - Country:US
Mailing Address - Phone:662-491-0326
Mailing Address - Fax:662-842-4944
Practice Address - Street 1:680 ROAD 1310
Practice Address - Street 2:
Practice Address - City:MOOREVILLE
Practice Address - State:MS
Practice Address - Zip Code:38857-7017
Practice Address - Country:US
Practice Address - Phone:662-491-0326
Practice Address - Fax:662-842-4944
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSR729159367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered