Provider Demographics
NPI:1568677136
Name:GALLAGHER, MAUREEN THERESE (RN, MSN, MPH)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:THERESE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:RN, MSN, MPH
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3004 WARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2425
Mailing Address - Country:US
Mailing Address - Phone:216-965-2847
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109
Practice Address - Country:US
Practice Address - Phone:216-965-2847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP 09408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily