Provider Demographics
NPI:1952744302
Name:PEAK, GAIL MICHELE
Entity Type:Individual
Prefix:MISS
First Name:GAIL
Middle Name:MICHELE
Last Name:PEAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 E THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-7535
Mailing Address - Country:US
Mailing Address - Phone:812-701-2103
Mailing Address - Fax:
Practice Address - Street 1:860 E THORNTON RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-7535
Practice Address - Country:US
Practice Address - Phone:812-701-2103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program