Provider Demographics
NPI:1821573577
Name:GALVIN, LAUREL (APRN)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:GALVIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1233
Mailing Address - Country:US
Mailing Address - Phone:603-536-3700
Mailing Address - Fax:603-536-5384
Practice Address - Street 1:71 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1233
Practice Address - Country:US
Practice Address - Phone:603-536-3700
Practice Address - Fax:603-536-5384
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH062884-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3115071Medicaid