Healthcare Provider Details

I. General information

NPI: 1508778937
Provider Name (Legal Business Name): JENNIE ROSE GALVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 E PENNSYLVANIA AVE
REDLANDS CA
92374-4707
US

IV. Provider business mailing address

1217 E PENNSYLVANIA AVE
REDLANDS CA
92374-4707
US

V. Phone/Fax

Practice location:
  • Phone: 909-913-3192
  • Fax:
Mailing address:
  • Phone: 909-913-3192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number729878
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: