Provider Demographics
NPI:1730728098
Name:CRAGG, GAYLA DENISE (CRNP-PMH)
Entity type:Individual
Prefix:MS
First Name:GAYLA
Middle Name:DENISE
Last Name:CRAGG
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HUDLER LN
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901-2045
Mailing Address - Country:US
Mailing Address - Phone:443-907-0717
Mailing Address - Fax:
Practice Address - Street 1:604 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2227
Practice Address - Country:US
Practice Address - Phone:443-907-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR130688363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health