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General NPI Number Information
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NPI Number | 1396888970
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Entity Type | Individual
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Provider Name | TRACY RUTH GALLAGHER CPNP
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 19100 DR JOHN LAMBERT DR
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City | HAMMOND
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State | LA
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Zip | 70403-0922
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Country | US
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Telephone | 985-247-4567
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Fax | 985-467-0896
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Provider Business Mailing Address
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Address Line | 38085 HIGHWAY 621
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City | GONZALES
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State | LA
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Zip | 70737-6052
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Country | US
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Telephone | 225-252-5644
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APO5128
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License Number State | LA
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