Provider Demographics
NPI:1568479285
Name:GALE, LINDA L (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:GALE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-250-2833
Mailing Address - Fax:828-651-6559
Practice Address - Street 1:472 RANKIN DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-6568
Practice Address - Country:US
Practice Address - Phone:828-652-1400
Practice Address - Fax:828-659-7829
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001728363A00000X
NC0010-05736363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT10728OtherCONNECTICARE
CT2V7941OtherHEALTH NET
TINOtherCORVEL
CT290001728CT01OtherANTHEM BC/BS
TINOtherNORHTEAST HEALTH DIRECT
TINOtherMULTIPLAN
TINOtherBERLEY ADMINISTRARTOR
CTG132277OtherINTEGRATED HEALTH PLAN
TINOtherNORHTEAST HEALTH DIRECT