Healthcare Provider Details

I. General information

NPI: 1215349741
Provider Name (Legal Business Name): GAIL STEARLEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N BEAVER ST BLDG 6
FLAGSTAFF AZ
86001-3148
US

IV. Provider business mailing address

PO BOX 3076
FLAGSTAFF AZ
86003-3076
US

V. Phone/Fax

Practice location:
  • Phone: 928-527-4325
  • Fax: 928-527-3427
Mailing address:
  • Phone: 928-301-4416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5613
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: