Basic Information
Provider Information
NPI: 1760638597
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GANO
FirstName: GAIL
MiddleName: H.
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TOEPPER
OtherFirstName: GAIL
OtherMiddleName: HUNT
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNP
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 850489
Address2:  
City: MOBILE
State: AL
PostalCode: 366850489
CountryCode: US
TelephoneNumber: 2513423949
FaxNumber: 2516313361
Practice Location
Address1: 6701 AIRPORT BLVD
Address2: STE A101
City: MOBILE
State: AL
PostalCode: 366086705
CountryCode: US
TelephoneNumber: 2516338880
FaxNumber: 2516332817
Other Information
ProviderEnumerationDate: 08/12/2008
LastUpdateDate: 09/01/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X1-052614ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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