Provider Demographics
NPI:1821296120
Name:GALLAGHER, CYNYHIA ANN (RN)
Entity Type:Individual
Prefix:
First Name:CYNYHIA
Middle Name:ANN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17536 SHELTER CT
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95946-9534
Mailing Address - Country:US
Mailing Address - Phone:530-277-5821
Mailing Address - Fax:
Practice Address - Street 1:17536 SHELTER CT
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95946-9534
Practice Address - Country:US
Practice Address - Phone:530-277-5821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458236163WH0200X, 163WC0400X, 163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase Management
Not Answered163WI0600XNursing Service ProvidersRegistered NurseInfection Control