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NPI Code Detail

MEDICARE: MEGAN JO GALLOWAY CNM

MEDICARE: MEGAN JO GALLOWAY CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice MidwifeCA
2176B00000XMidwifeCA

General Provider Information

NPI Number : 1376053702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN JO GALLOWAY CNM
Provider Business Mailing Address
First Line : 7950 KIPLING ST STE 201
Second Line :
City : ARVADA
State : CO
Zip : 80005-3926
Country : US
Telephone Number : 303-424-6466
Fax Number : 303-420-8944
Provider Business Practice Location Address
First Line : 2175 SOUTH AVE
Second Line :
City : SOUTH LAKE TAHOE
State : CA
Zip : 96150-7024
Country : US
Telephone Number : 530-543-5711
Fax Number : 530-544-2503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2017
Last Update Date : 12/09/2024

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