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General NPI Number Information
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NPI Number | 1043767874
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Entity Type | Individual
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Provider Name | KELLY GALLO WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 1265 CREEKSIDE PKWY STE 200
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City | NAPLES
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State | FL
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Zip | 34108-1954
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Country | US
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Telephone | 239-513-1992
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Fax | 239-513-9022
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Provider Business Mailing Address
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Address Line | 1265 CREEKSIDE PKWY STE 200
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City | NAPLES
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State | FL
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Zip | 34108-1954
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Country | US
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Telephone | 239-513-1992
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Fax | 239-513-9022
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024173939
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License Number State | VA
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