Provider Demographics
NPI:1285476515
Name:NAGEL, GINA LEE
Entity type:Individual
Prefix:
First Name:GINA LEE
Middle Name:
Last Name:NAGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24427 WILD WEST CIR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6132
Mailing Address - Country:US
Mailing Address - Phone:951-712-1376
Mailing Address - Fax:
Practice Address - Street 1:21633 AVENUE 24
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-9650
Practice Address - Country:US
Practice Address - Phone:559-665-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program