| NPI | 1235408691 |
|---|---|
| Former Name | STEPHANIE KELLY GALLAGHER, BREVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 12021-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN585810) |
| 163W00000X Registered Nurse (Licence: MN R212599-6) | |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP011850) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R212599-6) | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2022-07-28 |