Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 3854 | MN |
N | 363LW0102X | Nurse Practitioner - Women's Health | LH-0000176 | DE |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 22630007 | MN |
NPI | 1013934793 |
---|---|
Provider Name | Ms. Gayle Anne Fosterling-Pearson |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 07/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q63889 | (02) | DE |