Individual
ASHLEY GALLUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2817 SE 91ST ST, MOORE, OK 73160-9123
(405) 371-5729
Mailing address
2817 SE 91ST ST, MOORE, OK 73160-9123
(405) 371-5729
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R0101320
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
101320
OK
Other
Enumeration date
06/10/2016
Last updated
07/29/2019
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