MEDICARE: GINA GALLE R.N.

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
1	163W00000X	Registered Nurse	RN61242	NV

General Provider Information

NPI Number	:	1023257029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA GALLE R.N.

Provider Business Mailing Address
First Line	:	572 SUGARPINE DR
Second Line	:
City	:	INCLINE VILLAGE
State	:	NV
Zip	:	89451-8414
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	572 SUGARPINE DR
Second Line	:
City	:	INCLINE VILLAGE
State	:	NV
Zip	:	89451-8414
Country	:	US
Telephone Number	:	425-232-2357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2009
Last Update Date	:	02/13/2009

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