Provider Demographics
NPI:1619159498
Name:GALLOWAY, CYNTHIA R
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:R
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 EXETER DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35206-2845
Mailing Address - Country:US
Mailing Address - Phone:205-854-2772
Mailing Address - Fax:205-854-5284
Practice Address - Street 1:433 EXETER DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35206-2845
Practice Address - Country:US
Practice Address - Phone:205-854-2772
Practice Address - Fax:205-854-5284
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1058231363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care