Healthcare Provider Details

I. General information

NPI: 1093630253
Provider Name (Legal Business Name): DANIELLE NICOLE GALLEGOS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 S K ST
ELWOOD IN
46036-2836
US

IV. Provider business mailing address

1519 S K ST
ELWOOD IN
46036-2836
US

V. Phone/Fax

Practice location:
  • Phone: 765-278-9917
  • Fax:
Mailing address:
  • Phone: 765-278-9917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number28245337A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: