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NPI 1629212212

NPI 1629212212 : BRANDI GALLOWAY CRNP : BALTIMORE, MD

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General NPI Number Information
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    NPI Number           |    1629212212
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    Entity Type          |    Individual 
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    Provider Name        |    BRANDI GALLOWAY CRNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/27/2009
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    Last Update Date     |    12/09/2024
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Provider Practice Location Address
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    Address Line         |    1111 N CHARLES ST 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21201-5505
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    Country              |    US
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    Telephone            |    410-837-2050
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6201 GREENLEIGH AVE 
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    City                 |    MIDDLE RIVER
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    State                |    MD
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    Zip                  |    21220-2004
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    Country              |    US
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    Telephone            |    410-933-6423
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    Fax                  |    410-500-4266
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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       |    0024168246
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    License Number State |    VA
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Taxonomy #2
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    Taxonomy Code        |    363LW0102X
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    Taxonomy Name        |    Women's Health Nurse Practitioner
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    License Number       |    AC001949
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    License Number State |    MD
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