Healthcare Provider Details

I. General information

NPI: 1447250071
Provider Name (Legal Business Name): PAMOLA SUE GALE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 02/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 16TH ST
GREELEY CO
80631
US

IV. Provider business mailing address

1801 16TH ST
GREELEY CO
80631
US

V. Phone/Fax

Practice location:
  • Phone: 970-810-3894
  • Fax: 970-810-3897
Mailing address:
  • Phone: 970-810-3894
  • Fax: 970-810-3897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-2133
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number113927
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: