Provider Demographics
NPI:1881487098
Name:GASTON, ANITA RACHEL (RN)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:RACHEL
Last Name:GASTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3146 WILLIAMS HILL RD
Mailing Address - Street 2:
Mailing Address - City:BLUFF POINT
Mailing Address - State:NY
Mailing Address - Zip Code:14478-9719
Mailing Address - Country:US
Mailing Address - Phone:315-694-1112
Mailing Address - Fax:
Practice Address - Street 1:141 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEUKA PARK
Practice Address - State:NY
Practice Address - Zip Code:14478-9764
Practice Address - Country:US
Practice Address - Phone:315-279-5368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY370047-01163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health