Provider Demographics
NPI:1740767888
Name:GALLO, DANIELLE KATHY (RN)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:KATHY
Last Name:GALLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:KATHY
Other - Last Name:BAITINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:430 ALANDELE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3153
Mailing Address - Country:US
Mailing Address - Phone:414-305-0902
Mailing Address - Fax:
Practice Address - Street 1:430 ALANDELE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3153
Practice Address - Country:US
Practice Address - Phone:414-305-0902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-22
Last Update Date:2018-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA772410163W00000X
WI149390163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse