Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 1-148622 | AL |
NPI | 1023652625 |
---|---|
Provider Name | Mrs. Maura Owens Galvez |
First Address | Groveoak, AL 35975-4109 |
Second Address | Scottsboro, AL 35768-2841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2019 |
Last Update Date | 15/07/2021 |