Healthcare Provider Details

I. General information

NPI: 1376959056
Provider Name (Legal Business Name): CHERYLE GALLAGHER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FREEDOM DR
NAPOLEON OH
43545-9038
US

IV. Provider business mailing address

600 FREEDOM DR
NAPOLEON OH
43545-9038
US

V. Phone/Fax

Practice location:
  • Phone: 419-599-1660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN246163
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: