Individual
MARY GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
26908 DETROIT RD STE 103, WESTLAKE, OH 44145-2399
(440) 249-0274
Mailing address
26908 DETROIT RD STE 103, WESTLAKE, OH 44145-2399
(440) 249-0274
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.17955NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COA.17955NP
STATE MEDICAL LICENSE
OH
Enumeration date
10/14/2015
Last updated
10/14/2015
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