Provider Demographics
NPI:1245300128
Name:GUTHRIE, GALE ALICE (LPN)
Entity type:Individual
Prefix:
First Name:GALE
Middle Name:ALICE
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2078 SOUTHPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-6566
Mailing Address - Country:US
Mailing Address - Phone:727-239-0650
Mailing Address - Fax:
Practice Address - Street 1:2078 SOUTHPOINTE DR
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6566
Practice Address - Country:US
Practice Address - Phone:727-239-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31328-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse