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Individual

GLEE FRANCES GILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0633
SD
363A00000X
Physician Assistant
Primary
814
CO
363A00000X
Physician Assistant
PA10004485
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
199380
WA L & I
05
33273286
CO
01
6059GL
REGENCE BS
01
814
COLORADO LICENSE
CO
05
8355539
WA
01
8906873
WA CRIME VICTIMS
Enumeration date
06/03/2006
Last updated
10/12/2010
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