Healthcare Provider Details

I. General information

NPI: 1659857282
Provider Name (Legal Business Name): WHITNEY M GALLOWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4578 GALLIA PIKE
FRANKLIN FURNACE OH
45629-8600
US

IV. Provider business mailing address

923 FINDLAY ST
PORTSMOUTH OH
45662-4148
US

V. Phone/Fax

Practice location:
  • Phone: 740-351-0008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberSTNA.401912651116
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: