Healthcare Provider Details

I. General information

NPI: 1235657289
Provider Name (Legal Business Name): KRISTINA GALLANT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 MERRIAM AVE
LEOMINSTER MA
01453-3175
US

IV. Provider business mailing address

114 MERRIAM AVE STE 101
LEOMINSTER MA
01453-3175
US

V. Phone/Fax

Practice location:
  • Phone: 978-534-3399
  • Fax:
Mailing address:
  • Phone: 978-534-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN281732
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN281732
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: