Individual
TERESA A GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2320 N LAKE DR, SUITE 3603, MILWAUKEE, WI 53211-4507
(414) 270-4932
(414) 291-5195
Mailing address
4425 N PORT WASHINGTON RD, CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 270-4932
(414) 291-5195
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2127
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43996600
—
WI
Enumeration date
11/01/2006
Last updated
02/04/2014
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