Provider Demographics
NPI:1205611563
Name:GALE, CHERYL ELAINE (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELAINE
Last Name:GALE
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
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 641
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75657-0641
Mailing Address - Country:US
Mailing Address - Phone:903-503-0583
Mailing Address - Fax:
Practice Address - Street 1:4400-3 E CENTRAL TEXAS EXPY STE D
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-7396
Practice Address - Country:US
Practice Address - Phone:254-300-1337
Practice Address - Fax:512-777-4067
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1082984367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife