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Individual

GAYLE S FREDERE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
6508 BIENVILLE CT, MOBILE, AL 36695-3259
(251) 709-6980
Mailing address
6508 BIENVILLE CT, MOBILE, AL 36695-3259
(251) 709-6980

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
1-024624
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1024624
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000057537
AL
01
051057537
BC OF AL
AL
01
115135
MEDICAID AOC
AL
01
115141
MEDICAID SMC
AL
01
511-00430
BCBS OF ALABAMA SMC
AL
01
511-00442
BCBS OF AL - AOC
AL
Enumeration date
09/21/2005
Last updated
12/12/2013
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