Provider Demographics
NPI:1063651008
Name:STOTLER, GAIL A (CRNP)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:A
Last Name:STOTLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 MENOHER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-2839
Mailing Address - Country:US
Mailing Address - Phone:814-534-3119
Mailing Address - Fax:814-539-4137
Practice Address - Street 1:891 MENOHER BLVD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-2839
Practice Address - Country:US
Practice Address - Phone:814-534-3119
Practice Address - Fax:814-539-4137
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005741B363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA034057Medicare PIN