Healthcare Provider Details

I. General information

NPI: 1841399649
Provider Name (Legal Business Name): GAYLE REED CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 05/21/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 COUNTY ROAD, HWY 475, STE 100
OXFORD FL
34744
US

IV. Provider business mailing address

1132 COUNTY ROAD, HWY 475, STE 100
OXFORD FL
34744
US

V. Phone/Fax

Practice location:
  • Phone: 352-427-0794
  • Fax:
Mailing address:
  • Phone: 352-427-0794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP679242
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: