Healthcare Provider Details

I. General information

NPI: 1710925458
Provider Name (Legal Business Name): JOANNE M GALLAGHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 HIGHWAY 153 # 2426
HIXSON TN
37343-4520
US

IV. Provider business mailing address

5120 HIGHWAY 153 # 2426
HIXSON TN
37343-4520
US

V. Phone/Fax

Practice location:
  • Phone: 423-667-8398
  • Fax:
Mailing address:
  • Phone: 423-648-4500
  • Fax: 423-855-7563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN0000123113
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN7853
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: