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General NPI Number Information
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NPI Number | 1023849890
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Entity Type | Organization
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Legal Business Name | GALLARON GROUP LLC
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Dates
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Enumeration Date | 08/12/2024
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 9788 GILESPIE ST STE D-426
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City | LAS VEGAS
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State | NV
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Zip | 89183-7604
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Country | US
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Telephone | 702-588-9721
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Fax |
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Provider Business Mailing Address
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Address Line | 1136 VIA ROCCA
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City | HENDERSON
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State | NV
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Zip | 89052-0520
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Country | US
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Telephone | 702-588-9723
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JERRY J GALLARON
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Credential | NURSE PRACTITIONER
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Telephone | 702-588-9723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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