Healthcare Provider Details

I. General information

NPI: 1508180795
Provider Name (Legal Business Name): CHRISTINE GALLAGHER SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

1437 RIVERA ST
SAN FRANCISCO CA
94116-1755
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1565
  • Fax:
Mailing address:
  • Phone: 415-317-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number18644
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: