Provider Demographics
NPI:1811905722
Name:ULSHAFER, GAYLE LEE (CRNA MSN)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:LEE
Last Name:ULSHAFER
Suffix:
Gender:F
Credentials:CRNA MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:837 HARPER CT
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-2348
Mailing Address - Country:US
Mailing Address - Phone:805-361-0387
Mailing Address - Fax:805-354-0342
Practice Address - Street 1:837 HARPER CT
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-2348
Practice Address - Country:US
Practice Address - Phone:805-361-0387
Practice Address - Fax:805-354-0342
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299944163W00000X
CA604367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN2999440Medicaid
CAZZZ88396ZMedicare ID - Type Unspecified