Basic Information
| Provider Information | |||||||||
| NPI: | 1225259526 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JENNINGS | ||||||||
| FirstName: | GAYLE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2275 SWALLOW HILL RD | ||||||||
| Address2: | BLDG. 2600 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152201656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122794522 | ||||||||
| FaxNumber: | 4122793416 | ||||||||
| Practice Location | |||||||||
| Address1: | 2275 SWALLOW HILL RD | ||||||||
| Address2: | BLDG. 2600 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152201656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122794522 | ||||||||
| FaxNumber: | 4122793416 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 07/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | UP006473V | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LF0000X | SP012668 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | SP012668 | 01 | PA | LICENSE | OTHER |