Provider Demographics
NPI:1417456724
Name:GALLERANI, STEVIE LEE (NP)
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:LEE
Last Name:GALLERANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COLLINS AVE # 201A
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-3755
Mailing Address - Country:US
Mailing Address - Phone:774-221-5700
Mailing Address - Fax:781-551-3396
Practice Address - Street 1:4 COLLINS AVE # 201A
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3755
Practice Address - Country:US
Practice Address - Phone:774-221-5700
Practice Address - Fax:781-551-3396
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2311180163W00000X
MA2311180363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse