Provider Demographics
NPI:1588225387
Name:GALLOWAY, BRANDY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-2500
Mailing Address - Country:US
Mailing Address - Phone:252-328-6841
Mailing Address - Fax:
Practice Address - Street 1:1001 E 5TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-2500
Practice Address - Country:US
Practice Address - Phone:252-328-6841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011886363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5011886OtherNP LICENSE