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Individual

WANDA KIM HUDSON-GALLOGLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, WHNP-BC

Contact information

Practice address
134 ANSLEY DR, SUITE 200, DAHLONEGA, GA 30533-1639
(706) 864-2155
(706) 374-7628
Mailing address
165 BLUE RIDGE OVERLOOK, BLUE RIDGE, GA 30513-4431
(706) 946-5600
(706) 374-7628

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
097026
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003148051A
GA
Enumeration date
01/31/2013
Last updated
05/30/2017
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