Provider Demographics
NPI:1649031808
Name:EICHHORN, GAIL MARIE
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:MARIE
Last Name:EICHHORN
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 1:775 FREDRICK CT APT 3
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-3405
Mailing Address - Country:US
Mailing Address - Phone:906-290-0272
Mailing Address - Fax:
Practice Address - Street 1:775 FREDRICK CT APT 3
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-3405
Practice Address - Country:US
Practice Address - Phone:906-290-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372500000XNursing Service Related ProvidersChore Provider