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Individual

SHALETA GALLOWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
25742 SKYE CT, FARMINGTON HILLS, MI 48336-1661
(313) 455-7745
Mailing address
25742 SKYE CT, FARMINGTON HILLS, MI 48336-1661
(313) 455-7745

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
17353
OH
164W00000X
Licensed Practical Nurse
240162
AZ
164W00000X
Licensed Practical Nurse
Primary
4703122868
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
N/A
MI
Enumeration date
03/03/2022
Last updated
03/03/2022
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