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General NPI Number Information
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NPI Number | 1851641971
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Entity Type | Individual
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Provider Name | MAUREEN JOAN GALLAGHER FNP
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Gender | Female
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 133 PARK ST
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City | MALONE
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State | NY
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Zip | 12953-1244
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Country | US
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Telephone | 518-483-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 605 S COOLIDGE ST
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City | MOSES LAKE
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State | WA
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Zip | 98837
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Country | US
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Telephone | 509-765-0674
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Fax | 509-764-0193
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 535830
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F337487-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60748114
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License Number State | WA
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