Healthcare Provider Details

I. General information

NPI: 1346643079
Provider Name (Legal Business Name): ANA GURLEY R.N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 BUENA VISTA DR
GREENWICH CT
06831-4210
US

IV. Provider business mailing address

37 BUENA VISTA DR
GREENWICH CT
06831-4210
US

V. Phone/Fax

Practice location:
  • Phone: 917-915-6977
  • Fax:
Mailing address:
  • Phone: 917-915-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number22 474971
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: