Healthcare Provider Details

I. General information

NPI: 1871799494
Provider Name (Legal Business Name): JANET M GALLANT WOOD MSN,ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET M. GALLANT MSN,RNC

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WASHINGTON ST
WINCHESTER MA
01890-1328
US

IV. Provider business mailing address

620 WASHINGTON ST
WINCHESTER MA
01890-1328
US

V. Phone/Fax

Practice location:
  • Phone: 781-279-4064
  • Fax:
Mailing address:
  • Phone: 781-279-4064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number168375
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: