Healthcare Provider Details

I. General information

NPI: 1174518872
Provider Name (Legal Business Name): JULIE A GALLAGHER RN/NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 10/31/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 BOSTON ROAD SUITE 4
NORTH BILLERICA MA
01862-2321
US

IV. Provider business mailing address

221 BOSTON ROAD SUITE 4
NORT BILLERICA MA
01862-2321
US

V. Phone/Fax

Practice location:
  • Phone: 978-670-1300
  • Fax: 978-528-2024
Mailing address:
  • Phone: 978-670-1300
  • Fax: 978-528-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number187104
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: