Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5007076 | NC |
NPI | 1013326776 |
---|---|
Provider Name | Sean Thomas Gallagher |
First Address | Chapel Hill, NC 27514-4220 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2014 |
Last Update Date | 07/08/2014 |