Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | LG-0000534 | DE |
NPI | 1003126764 |
---|---|
Provider Name | Kathy Elaine Gallagher |
First Address | Newark, DE 19713 |
Second Address | Newark, DE 19713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2010 |
Last Update Date | 15/10/2010 |