Basic Information
| Provider Information | |||||||||
| NPI: | 1568479285 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GALE | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 602373 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282602373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282502833 | ||||||||
| FaxNumber: | 8286516559 | ||||||||
| Practice Location | |||||||||
| Address1: | 472 RANKIN DR | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287526568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286521400 | ||||||||
| FaxNumber: | 8286597829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 02/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 001728 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 0010-05736 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 10728 | 01 | CT | CONNECTICARE | OTHER | 2V7941 | 01 | CT | HEALTH NET | OTHER | TIN | 01 | CORVEL | OTHER | 290001728CT01 | 01 | CT | ANTHEM BC/BS | OTHER | TIN | 01 | NORHTEAST HEALTH DIRECT | OTHER | TIN | 01 | MULTIPLAN | OTHER | TIN | 01 | BERLEY ADMINISTRARTOR | OTHER | G132277 | 01 | CT | INTEGRATED HEALTH PLAN | OTHER |