Individual
MS. MICHAELA C GALLAGHER-GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2212 BROTHERS RD, SANTA FE, NM 87505-6903
(502) 983-9460
(505) 983-0568
Mailing address
1923 KIVA RD, SANTA FE, NM 87505-3314
(505) 983-2980
(505) 983-2980
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
NM 94 PA 34
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM 94 PA 34
MEDICAL LICENSE
NM
Enumeration date
01/08/2007
Last updated
03/07/2023
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