Individual
GAIL M GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
205 S FRONT ST, 4TH FLOOR, BMA, HARRISBURG, PA 17104-1619
(717) 231-8555
(717) 231-8568
Mailing address
409 SOUTH FRONT ST, STE 2F, HARRISBURG, PA 17104-1621
(717) 231-8555
(717) 231-8568
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN644665
PA
363LA2200X
Adult Health Nurse Practitioner
Primary
SP012635
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103079740
—
PA
Enumeration date
01/20/2007
Last updated
01/02/2021
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