Provider Demographics
NPI:1578533097
Name:GALGANO, JENNIFER JEAN (CPNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JEAN
Last Name:GALGANO
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 INGRAM RD
Mailing Address - Street 2:1801
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1448
Mailing Address - Country:US
Mailing Address - Phone:325-518-3255
Mailing Address - Fax:
Practice Address - Street 1:2200 BERGQUIST DRIVE, ATTN: CREDENTIALS (CME)
Practice Address - Street 2:SUITE 1
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-5300
Practice Address - Country:US
Practice Address - Phone:510-292-6707
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14372363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics