MEDICARE: AMANDA MARIE GALLAHUE

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
1	163W00000X	Registered Nurse	R1612581	MN

General Provider Information

NPI Number	:	1730046384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE GALLAHUE

Provider Business Mailing Address
First Line	:	8088 COREY PATH
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55076-3358
Country	:	US
Telephone Number	:	612-725-8022
Fax Number	:

Provider Business Practice Location Address
First Line	:	8088 COREY PATH
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55076-3358
Country	:	US
Telephone Number	:	612-725-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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