MEDICARE: GAIL JOAN AMMONS CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	UP000331	PA
2	363LP2300X	Primary Care Nurse Practitioner	UP000331	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1551673	OTHER	PA	GATEWAY-WMG
2	20019274	OTHER	PA	AMERIHEALTH MERCY-WMG
3	618278	OTHER	MD	CAREFIRST MD BCBS
4	50000129	OTHER	PA	CAPITAL BLUE CROSS
5	039286	OTHER	PA	JOHNS HOPKINS

General Provider Information

NPI Number	:	1770512279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL JOAN AMMONS CRNP

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-851-5736
Fax Number	:	717-851-6162

Provider Business Practice Location Address
First Line	:	300 PINE GROVE COMMONS
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17403-5176
Country	:	US
Telephone Number	:	717-851-5736
Fax Number	:	717-851-6162

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	02/11/2015

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