Healthcare Provider Details

I. General information

NPI: 1104267251
Provider Name (Legal Business Name): GWENDOLYN DAY CRNP, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 S WASHINGTON AVE
MOBILE AL
36603-1301
US

IV. Provider business mailing address

3737 GOVERNMENT BLVD STE 408
MOBILE AL
36693-4362
US

V. Phone/Fax

Practice location:
  • Phone: 251-433-2642
  • Fax: 251-433-2642
Mailing address:
  • Phone: 251-602-1911
  • Fax: 251-602-1850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number1-074486
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-074486
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: