Provider Demographics
NPI:1497755938
Name:GALLAGHER, MARY PATRICIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:PATRICIA
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:PATRICIA
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5712 RIO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2433
Mailing Address - Country:US
Mailing Address - Phone:301-330-0886
Mailing Address - Fax:
Practice Address - Street 1:5712 RIO VISTA DR
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2433
Practice Address - Country:US
Practice Address - Phone:301-330-0886
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR092261163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant