MEDICARE: ANGELA M GALLAHAR APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71012456A	IN

General Provider Information

NPI Number	:	1043951858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M GALLAHAR APRN, FNP-C

Provider Business Mailing Address
First Line	:	1950 STATE ST
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-4920
Country	:	US
Telephone Number	:	812-948-8305
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 STATE ST
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-4920
Country	:	US
Telephone Number	:	812-948-8305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	08/10/2022

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