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General NPI Number Information
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NPI Number | 1821448226
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Entity Type | Individual
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Provider Name | LORA LYNN GALLOWAY FNP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 7818 S REDWOOD RD
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City | WEST JORDAN
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State | UT
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Zip | 84088-4002
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Country | US
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Telephone | 801-565-8299
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Fax |
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Provider Business Mailing Address
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Address Line | 2118 E ASH DOWN LN
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City | DRAPER
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State | UT
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Zip | 84020-2513
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Country | US
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Telephone | 202-361-0084
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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 | 9322223
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License Number State | FL
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