Provider Demographics
NPI:1336228337
Name:FIELD, GLADYS DESCARGAR (MSN, APRN, ACNP-BC)
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:DESCARGAR
Last Name:FIELD
Suffix:
Gender:F
Credentials:MSN, APRN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4460 BROAD ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-8065
Mailing Address - Country:US
Mailing Address - Phone:805-597-6715
Mailing Address - Fax:805-541-4973
Practice Address - Street 1:4460 BROAD ST STE 110
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-8065
Practice Address - Country:US
Practice Address - Phone:805-597-6715
Practice Address - Fax:805-541-4973
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 16524363LA2100X
CA16524363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care