Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | VP-005941C | PA |
NPI | 1003068826 |
---|---|
Provider Name | Teresa Marie Gallagher |
First Address | Lancaster, PA 17601-2644 |
Second Address | Millersville, PA 17551-1607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2008 |
Last Update Date | 28/09/2016 |