Provider Demographics
NPI:1831961556
Name:GALLAN, DANIELLE MARIE (FNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:GALLAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:LANPHEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 DONAHUE WAY
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-1639
Mailing Address - Country:US
Mailing Address - Phone:508-326-9885
Mailing Address - Fax:
Practice Address - Street 1:101 DONAHUE WAY
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1639
Practice Address - Country:US
Practice Address - Phone:508-326-9885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2302594163W00000X, 363LF0000X
RIRN76783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse