Individual
MISTY JO GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP-PC
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
Mailing address
1101 LAMBSDOWNE LN, WEST LAFAYETTE, IN 47906-8717
(707) 628-5827
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28152890A
IN
163W00000X
Registered Nurse
604722
CA
163WN0002X
Neonatal Intensive Care Registered Nurse
28152890C
IN
363LP0200X
Pediatric Nurse Practitioner
28152890A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71014809A
IN
390200000X
Student in an Organized Health Care Education/Training Program
28152890A
IN
Other
Enumeration date
08/22/2022
Last updated
01/16/2024
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