Healthcare Provider Details

I. General information

NPI: 1043390909
Provider Name (Legal Business Name): ANN GALLIGAN ED D RN CS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MOHAWK DRIVE
LEOMINSTER MA
01453
US

IV. Provider business mailing address

12 ROUND HILL RD
WESTON MA
02493
US

V. Phone/Fax

Practice location:
  • Phone: 978-840-1100
  • Fax: 508-792-1514
Mailing address:
  • Phone: 781-893-3386
  • Fax: 781-893-0813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number94600
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: