Provider Demographics
NPI:1831392687
Name:GALLAGHER, KARYN JANSEN (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:JANSEN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SINGLETON RIDGE RD
Mailing Address - Street 2:ATTN PNS CREDENTIALING
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:843-234-6946
Mailing Address - Fax:
Practice Address - Street 1:251 UNIVERSITY BLVD
Practice Address - Street 2:STE B
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8834
Practice Address - Country:US
Practice Address - Phone:843-347-1012
Practice Address - Fax:843-347-1218
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3534363LX0001X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3534OtherWONEM'S HEALTH NURSE PRACTITIONER LICENSE NUMBER