Provider Demographics
NPI:1154440717
Name:ZIEGLER, GAYLE DELORA (RPH)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:DELORA
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 UNIVERSITY DR S
Mailing Address - Street 2:SANFORD PHAMACY SOUTH UNIVERSITY
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4940
Mailing Address - Country:US
Mailing Address - Phone:701-280-4467
Mailing Address - Fax:701-280-4643
Practice Address - Street 1:1720 UNIVERSITY DR S
Practice Address - Street 2:SANFORD PHARMACY SOUTH UNIVERSITY
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4940
Practice Address - Country:US
Practice Address - Phone:701-280-4467
Practice Address - Fax:701-280-4643
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4127183500000X
MN114252-7183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist