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General NPI Number Information
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NPI Number | 1639830441
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Entity Type | Individual
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Provider Name | TIFFANI MICHELLE GALLIMORE APRN, CNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 7901 SCHATZ POINTE DR
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City | CENTERVILLE
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State | OH
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Zip | 45459-3824
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Country | US
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Telephone | 937-438-9841
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Fax | 937-438-9851
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Provider Business Mailing Address
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Address Line | 1256 ASHLAND AVE
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City | DAYTON
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State | OH
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Zip | 45420-1504
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Country | US
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Telephone | 937-369-3234
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0030477
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License Number State | OH
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