Healthcare Provider Details

I. General information

NPI: 1871712885
Provider Name (Legal Business Name): KERI A GALVAN R.N., BSN, LNC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 MONARDA PL
REYNOLDSBURG OH
43068-6716
US

IV. Provider business mailing address

842 MONARDA PL
REYNOLDSBURG OH
43068-6716
US

V. Phone/Fax

Practice location:
  • Phone: 785-341-2581
  • Fax: 614-986-7700
Mailing address:
  • Phone: 785-341-2581
  • Fax: 614-986-7700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number299173
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: