Individual
STEVEN GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP/FNP-BC
Contact information
Practice address
245 VINE AVE, LAS ANIMAS, CO 81054
(719) 456-2653
(719) 456-0105
Mailing address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 589-5161
(719) 589-5722
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
NP-10184
CO
363LF0000X
Family Nurse Practitioner
Primary
NP-10184
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58304568
—
CO
Enumeration date
09/13/2012
Last updated
09/01/2013
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