Provider Demographics
NPI:1275187676
Name:GALVIS, WELKY ALEXANDRA (FNP)
Entity Type:Individual
Prefix:
First Name:WELKY
Middle Name:ALEXANDRA
Last Name:GALVIS
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 1:27 CONGRESS ST STE 513
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5523
Mailing Address - Country:US
Mailing Address - Phone:978-744-8388
Mailing Address - Fax:
Practice Address - Street 1:47 CONGRESS STREET
Practice Address - Street 2:SALEM FAMILY HEALTH CENTER
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-744-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2296565207RG0300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110157633AMedicaid