person
Gail L Shively, NP
Family Nurse Practitioner in Fort Wayne, Indiana
NPI 1699792630

Gail L Shively is a Family Nurse Practitioner based in Fort Wayne, IN and is specialized in Family. Gail L Shively practices in Fort Wayne, IN and has the professional credentials of NP. The NPI Number for Gail L Shively is 1699792630 and holds a License No. 71002080A (Indiana).

The current practice location address for Gail L Shively is 7916 W Jefferson Blvd, Fort Wayne, IN and can be reached out via phone at 260-432-2297 and via fax at 260-479-2950.

Location: 7916 W Jefferson Blvd, Fort Wayne, IN, 46804-7934
person
Provider Profile Details
NPI Number
1699792630
Provider Name
Gail L Shively
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
7916 W Jefferson Blvd, Fort Wayne, IN, 46804-7934
Phone Number
260-432-2297
Fax Number
260-479-2950
Provider Enumeration Date
07/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200878280 05 IN
institution
Provider Business Practice Location Address Details
Address
7916 W Jefferson Blvd
City
State
Zip
46804-4140
Phone Number
260-432-2297
Fax Number
260-479-2950
person
Provider Business Mailing Address Details
Address
7916 W Jefferson Blvd
City
State
Zip
46804-4140
Phone Number
260-432-2297
Fax Number
260-479-2950
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
71002080A (Indiana)
Definition
Definition to come...
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