Healthcare Provider Details

I. General information

NPI: 1982086815
Provider Name (Legal Business Name): KATHERINE GALLOWAY NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2015
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 S VAL VISTA DR
GILBERT AZ
85297-7323
US

IV. Provider business mailing address

2108 E THOMAS RD STE 130
PHOENIX AZ
85016-7761
US

V. Phone/Fax

Practice location:
  • Phone: 602-933-6345
  • Fax:
Mailing address:
  • Phone: 602-933-1814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number161709
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP8130
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: