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General NPI Number Information
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NPI Number | 1679205009
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Entity Type | Individual
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Provider Name | JENNIFER ERIN GALLOWAY
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Gender | Female
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 234 E 1ST ST STE 17
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City | CASPER
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State | WY
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Zip | 82601-2516
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Country | US
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Telephone | 307-333-0034
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Fax |
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Provider Business Mailing Address
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Address Line | 71 MAGNOLIA ST APT 2
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City | CASPER
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State | WY
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Zip | 82604-4059
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Country | US
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Telephone | 307-267-3298
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 51869
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License Number State | WY
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