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Individual

MRS. SHATAZAMINE SHANNETTE GALLOWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP-C

Contact information

Practice address
433 COPPERFIELD BLVD NE, CONCORD, NC 28025-2405
(704) 796-7770
(704) 788-9351
Mailing address
3158 FREEDOM DR STE 3102, CHARLOTTE, NC 28208-0014
(704) 971-7099

Taxonomy

Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
311483
NC
363L00000X
Nurse Practitioner
Primary
5020177
NC
363LA2200X
Adult Health Nurse Practitioner
AG08230106
NC

Other

Enumeration date
08/30/2023
Last updated
04/30/2025
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