Provider Demographics
NPI:1245069921
Name:GALLION, BRELYN KIARA
Entity type:Individual
Prefix:
First Name:BRELYN
Middle Name:KIARA
Last Name:GALLION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10412 SAHLER PLZ # A
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3739
Mailing Address - Country:US
Mailing Address - Phone:402-676-1042
Mailing Address - Fax:
Practice Address - Street 1:7802 HASCALL ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3413
Practice Address - Country:US
Practice Address - Phone:402-390-6495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant