GAIL JEAN WALL PA NPI 1700092095

NPI Information

  • NPI: 1700092095
  • Provider Name: GAIL JEAN WALL, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 431 SOUTH KEECH STREET
    HALIFAX HEALTH KEECH CENTER
    DAYTONA BEACH, FL
    ZIP 32114
  • Phone: (386) 947-3553

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NPI Details

Gail Jean Wall, PA is a medical physician assistant in Daytona Beach, FL. Gail Jean Wall, PA NPI is 1700092095. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

431 SOUTH KEECH STREET
HALIFAX HEALTH KEECH CENTER
DAYTONA BEACH, FL
ZIP 32114-623
Phone: (386) 947-3553
Fax: (386) 239-6189

The enumeration date for this NPI number is 5/15/2007 and was last updated on 9/11/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA0001553FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1290055600MEDICAIDFLORIDA
2PA0001553OTHERFLORIDAPHYSICIAN ASSIST LICENSE
3E4847WMEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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