Provider Demographics
NPI:1376053702
Name:GALLOWAY, MEGAN JO (CNM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JO
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 KIPLING ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3926
Mailing Address - Country:US
Mailing Address - Phone:303-424-6466
Mailing Address - Fax:303-420-8944
Practice Address - Street 1:2175 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-7024
Practice Address - Country:US
Practice Address - Phone:530-543-5711
Practice Address - Fax:530-544-2503
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife