Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 35.135465 | OH |
N | 207V00000X | Obstetrician & Gynecologist | MD063871L | PA |
NPI | 1023028008 |
---|---|
Provider Name | Kathy Lynne Galla-Elizeus |
First Address | Norwalk, OH 44857-2480 |
Second Address | Norwalk, OH 44857 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 04/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0338195 | (05) | OH |
G94942 | (02) |