Individual
ROXANNE B GALL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
20 MEDICAL VILLAGE DR, SUITE 394, EDGEWOOD, KY 41017-5401
(859) 578-0442
(859) 578-9113
Mailing address
663 NELSON PL, NEWPORT, KY 41071-1742
(859) 578-0442
(859) 578-9113
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4348P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78013620
—
KY
Enumeration date
02/17/2006
Last updated
07/09/2007
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