Individual
SUSAN JENNIFER GALLUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,MSN,CPNP
Contact information
Practice address
36000 DARNALL LOOP, NEWBORN CLINIC 2ND FLOOR, FORT HOOD, TX 76544-5095
(254) 288-8440
Mailing address
36000 DARNALL LOOP, NEWBORN CLINIC 2ND FLOOR, FORT HOOD, TX 76544-5095
(254) 288-8440
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
612117
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1651853
—
TX
Enumeration date
08/19/2006
Last updated
08/18/2014
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