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NPI Code Detail

MEDICARE: MS. GALE ANN NORDYKE

MEDICARE: MS. GALE ANN NORDYKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1396969184
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GALE ANN NORDYKE
Provider Business Mailing Address
First Line : 2324 N EL PASO ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-7019
Country : US
Telephone Number : 719-290-0323
Fax Number :
Provider Business Practice Location Address
First Line : 10 FARRAGUT AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5626
Country : US
Telephone Number : 719-636-2122
Fax Number : 719-634-0069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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