Provider Demographics
NPI:1093869182
Name:GALANTE, JENNIFER LOUIS (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LOUIS
Last Name:GALANTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:LOUIS
Other - Last Name:GALANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4101 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048
Mailing Address - Country:US
Mailing Address - Phone:270-988-2978
Mailing Address - Fax:270-988-3900
Practice Address - Street 1:131 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:KY
Practice Address - Zip Code:42078-8043
Practice Address - Country:US
Practice Address - Phone:270-988-2978
Practice Address - Fax:270-988-3900
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02975207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000381058OtherANTHEM BCBS
I42853Medicare UPIN
KY3403505Medicare ID - Type Unspecified