Provider Demographics
NPI:1013530237
Name:GALVAN, KAYLEEN MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAYLEEN
Middle Name:MARIE
Last Name:GALVAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18262 GLEN OAK WAY
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3991
Mailing Address - Country:US
Mailing Address - Phone:703-727-0602
Mailing Address - Fax:
Practice Address - Street 1:18262 GLEN OAK WAY
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3991
Practice Address - Country:US
Practice Address - Phone:703-727-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001269620163W00000X
VA0024180122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse