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Individual

KATIE NICOLE GALLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-8507
(317) 968-1395
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003408A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102556007
ANTHEM PTAN
IN
05
300055752
IN
01
Q00765235
RAILROAD PTAN
IN
Enumeration date
09/29/2021
Last updated
11/04/2024
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