Individual
LARISSA MICHELLE GALLAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 681-5551
Mailing address
17 GOLDMONT ST, BLACK MOUNTAIN, NC 28711-2790
(828) 606-6804
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
5013701
NC
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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