Provider Demographics
NPI:1912970153
Name:BARR, GALE M (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:GALE
Middle Name:M
Last Name:BARR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:GALE
Other - Middle Name:M
Other - Last Name:LIBERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2946 E BANNER GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2165
Mailing Address - Country:US
Mailing Address - Phone:440-256-6444
Mailing Address - Fax:440-256-3682
Practice Address - Street 1:2946 E BANNER GATEWAY DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2165
Practice Address - Country:US
Practice Address - Phone:480-256-6444
Practice Address - Fax:480-256-3682
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-05068363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2451190Medicaid
OH000000325968OtherANTHEM
OHNP14441Medicare ID - Type Unspecified
OH2451190Medicaid