Provider Demographics
NPI:1912756784
Name:GALLO, AVERY POPE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AVERY
Middle Name:POPE
Last Name:GALLO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AVERY
Other - Middle Name:MACKENZIE
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20036 ZION AVENUE, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031
Mailing Address - Country:US
Mailing Address - Phone:910-308-1059
Mailing Address - Fax:
Practice Address - Street 1:20036 ZION AVENUE, SUITE 100
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031
Practice Address - Country:US
Practice Address - Phone:910-308-1059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical