Healthcare Provider Details

I. General information

NPI: 1225028384
Provider Name (Legal Business Name): JUDITH RITA GALLOB MSN,APRN-BC,ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: MRS. JUDITH RITA RUGLOSKI

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

IV. Provider business mailing address

32001 N 45TH ST
CAVE CREEK AZ
85331-5477
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-5210
  • Fax: 602-344-5997
Mailing address:
  • Phone: 480-488-6907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberRN-052786
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number000048
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: