Provider Demographics
NPI:1871568907
Name:ROCK, GAIL ANN (CNM)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:ANN
Last Name:ROCK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MON HEALTH MEDICAL PARK DR STE 2100
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1134
Mailing Address - Country:US
Mailing Address - Phone:304-599-6811
Mailing Address - Fax:304-599-7159
Practice Address - Street 1:2000 MON HEALTH MEDICAL PARK DR STE 2100
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-599-6811
Practice Address - Fax:304-599-7159
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN50130CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP21921Medicare UPIN
WVWV50130AOtherHEALTH PLAN
WV001343117OtherBLUE CROSS/BLUE SHIELD
WV3810001067Medicaid
WV9450028000Medicaid
WV001710351OtherBC/BS PAY TO #
WV2124357OtherUNITED HEALTHCARE/ MAMSI