Provider Demographics
NPI:1306957634
Name:MICHAELIS-OW, GAIL FAY (NP)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:FAY
Last Name:MICHAELIS-OW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-287-7532
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:1119 PACIFIC AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-7503
Practice Address - Country:US
Practice Address - Phone:831-426-5550
Practice Address - Fax:831-426-1178
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN258572363LA2200X
CARN 258572363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health