Provider Demographics
NPI:1689118457
Name:APPLE FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:APPLE FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GALA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC, MSN, FNP-C
Authorized Official - Phone:720-507-7488
Mailing Address - Street 1:11479 PINE DR
Mailing Address - Street 2:SUITE 17A
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7308
Mailing Address - Country:US
Mailing Address - Phone:720-507-7488
Mailing Address - Fax:
Practice Address - Street 1:11479 PINE DR
Practice Address - Street 2:SUITE 17A
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7308
Practice Address - Country:US
Practice Address - Phone:720-507-7488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO992250363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty