Healthcare Provider Details

I. General information

NPI: 1518856640
Provider Name (Legal Business Name): AMANDA ROSE GALYON APRN, ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3514 21ST ST
LUBBOCK TX
79410-1210
US

IV. Provider business mailing address

14116 AVENUE W
LUBBOCK TX
79423-7192
US

V. Phone/Fax

Practice location:
  • Phone: 806-725-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number955545
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1205677
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: