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General NPI Number Information
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NPI Number | 1205845534
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Entity Type | Individual
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Provider Name | GAIL SHUE CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 15205 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6072
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Country | US
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Telephone | 352-597-7744
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Fax | 352-597-7797
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Provider Business Mailing Address
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Address Line | 1439 GLENRIDGE DR
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City | SPRING HILL
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State | FL
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Zip | 34609-4937
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Country | US
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Telephone | 352-650-9087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN2609922
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License Number State | FL
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