Provider Demographics
NPI:1538360706
Name:GALIETTI, COLLEEN
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:GALIETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 H H BURCH RD
Mailing Address - Street 2:#5
Mailing Address - City:OAK HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32759-9586
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:298 H H BURCH RD
Practice Address - Street 2:#5
Practice Address - City:OAK HILL
Practice Address - State:FL
Practice Address - Zip Code:32759-9586
Practice Address - Country:US
Practice Address - Phone:386-846-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5156366164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse