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General NPI Number Information
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NPI Number | 1427450857
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Entity Type | Individual
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Provider Name | RACHEL GALLAGHER
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Gender | Female
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 230 SCHENK ST
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City | MADISON
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State | WI
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Zip | 53714-2331
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Country | US
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Telephone | 608-204-1504
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Fax | 608-204-0539
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Provider Business Mailing Address
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Address Line | 6790 MOON LIGHT CIR
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City | SUN PRAIRIE
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State | WI
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Zip | 53590-9112
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Country | US
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Telephone | 608-217-3440
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 74556
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License Number State | WI
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