Healthcare Provider Details

I. General information

NPI: 1972538973
Provider Name (Legal Business Name): GAIL PIELACK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RWBAHC 2240 WINROW RD
FORT HUACHUCA AZ
85613
US

IV. Provider business mailing address

2240 E WINROW AVE
FORT HUACHUCA AZ
85613
US

V. Phone/Fax

Practice location:
  • Phone: 520-533-9033
  • Fax:
Mailing address:
  • Phone: 480-862-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP2284
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberAP2284
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: