=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841615952
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GAYLE MCCROSSIN APRN FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2014
-----------------------------------------------------
Last Update Date | 02/26/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 CENTER DR 10/ 7D36B MSC 1428
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20814-1428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-443-3471
-----------------------------------------------------
Fax | 301-480-2286
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 CENTER DR HMCS/MNB/NINDS BLDG 10/ 7D36B MSC 1428
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20814-9692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-443-3471
-----------------------------------------------------
Fax | 301-480-2286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R174481
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------