Provider Demographics
NPI:1447250071
Name:GALE, PAMOLA SUE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:PAMOLA
Middle Name:SUE
Last Name:GALE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 16TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631
Mailing Address - Country:US
Mailing Address - Phone:970-810-3894
Mailing Address - Fax:970-810-3897
Practice Address - Street 1:1801 16TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631
Practice Address - Country:US
Practice Address - Phone:970-810-3894
Practice Address - Fax:970-810-3897
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP-2133363LF0000X
CO113927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16803531Medicaid
COP30974Medicare UPIN
CO16803531Medicaid
COCOA104662Medicare PIN