Provider Demographics
NPI:1629669213
Name:GALLAGHER, ANDREA MAE (FNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MAE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MAE
Other - Last Name:DIBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1524 W SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1728
Mailing Address - Country:US
Mailing Address - Phone:419-722-4864
Mailing Address - Fax:
Practice Address - Street 1:1818 CHAPEL DR STE C
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1344
Practice Address - Country:US
Practice Address - Phone:419-429-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.304614163W00000X
OHAPRN.CNP.0028359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse