Healthcare Provider Details

I. General information

NPI: 1154466969
Provider Name (Legal Business Name): GAIL PUCO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 POWELL ST
NORRISTOWN PA
19401-3323
US

IV. Provider business mailing address

1301 POWELL ST
NORRISTOWN PA
19401-3323
US

V. Phone/Fax

Practice location:
  • Phone: 610-270-2352
  • Fax: 610-270-2358
Mailing address:
  • Phone: 610-270-2352
  • Fax: 610-270-2358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN183234L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number030152
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: