| Doctor Name: | WANDA GAY GIFFORD |
| NPI Number: | 1194768010 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN-BC |
| License Number: | 71000809A |
| Business Practice Address: | 1104 E Grace St Rensselaer, IN - 479783211 |
| Business Phone Number: | 2198666121 |
| Business Fax Number: | 2198666321 |
| Mailing Address: | 1104e Grace St, RENSSELAER |
| State: | IN |
| Postal Code: | 479783296 |
| Phone Number: | 2198665141 |
| Fax Number: | 2198663234 |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 09/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 71000809A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |