Provider Demographics
NPI:1790124592
Name:GALLIAN, LAUREN C (FNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:GALLIAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 DICK LONAS RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1383
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-247-5371
Practice Address - Street 1:721 HIGHWAY 321 N STE C
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-5003
Practice Address - Country:US
Practice Address - Phone:865-986-3283
Practice Address - Fax:833-908-2121
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ000758Medicaid
TN10350I7410Medicare PIN