=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932656568
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN GALANEK APN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2016
-----------------------------------------------------
Last Update Date | 07/11/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1210 E 4TH ST
-----------------------------------------------------
City | BETHLEHEM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18015-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-408-0755
-----------------------------------------------------
Fax | 833-905-2298
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2291 HANNAHS LN
-----------------------------------------------------
City | BETHLEHEM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18020-4486
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-926-4669
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP020169
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 209014708
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------