Healthcare Provider Details

I. General information

NPI: 1548250822
Provider Name (Legal Business Name): LAURA LYNN GALLOWAY RN, MS, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N HOWARD ST
BALTIMORE MD
21201-3610
US

IV. Provider business mailing address

306 LOCHVIEW TER
TIMONIUM MD
21093-2711
US

V. Phone/Fax

Practice location:
  • Phone: 410-576-1414
  • Fax:
Mailing address:
  • Phone: 443-743-0941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR176894
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: