Basic Information
| Provider Information | |||||||||
| NPI: | 1396796363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BACKMEYER | ||||||||
| FirstName: | GAYLE | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21 | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461730021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659323699 | ||||||||
| FaxNumber: | 7659324164 | ||||||||
| Practice Location | |||||||||
| Address1: | 509 HARCOURT WAY | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461731165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659323699 | ||||||||
| FaxNumber: | 7659324164 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 72000025 | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.