Healthcare Provider Details

I. General information

NPI: 1821779141
Provider Name (Legal Business Name): AUDREY NICOLE GALICIA DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 FLEMING ST
GARDEN CITY KS
67846-6252
US

IV. Provider business mailing address

1021 FLEMING ST
GARDEN CITY KS
67846-6252
US

V. Phone/Fax

Practice location:
  • Phone: 620-287-2010
  • Fax:
Mailing address:
  • Phone: 620-287-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-85683-112
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: