Gackle, Elaine Marie

Gackle, Elaine Marie is an individual health care provider with primary practice located at 742 W Highland Ave , San Bernardino CA 92405-3839. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gackle, Elaine Marie can be contacted via phone (909) 213-0001.

Contact Information

Primary practice address
742 W Highland Ave San Bernardino CA 92405-3839
Phone: (909) 213-0001
Fax: (909) 386-1882
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP376074 California

Profile Details

NPI number 1093789000
LBN Legal business name Gackle, Elaine Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Oct 3rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093789000 NPPES
California Other RNP376074 LICENSE

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