Provider Demographics
NPI:1295536639
Name:GALLOWAY, KELSEY BAKER (FNP-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:BAKER
Last Name:GALLOWAY
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5270 HIGHWAY 18 W
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:35555-5723
Mailing Address - Country:US
Mailing Address - Phone:205-270-1704
Mailing Address - Fax:
Practice Address - Street 1:1034 TEMPLE AVE N
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:AL
Practice Address - Zip Code:35555-1924
Practice Address - Country:US
Practice Address - Phone:205-710-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-179180163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse