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Individual
MRS. JENNIFER MARIE GALLAGHER
Active
Individual
MRS. JENNIFER MARIE GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001000396
NC
363A00000X
Physician Assistant
Primary
PA 21721
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA21721
CA PA LICENSE
CA
Enumeration date
09/05/2006
Last updated
09/20/2011
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