Provider Demographics
NPI:1538805320
Name:GALLAGHER, KRISTINE E (ACNP)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:E
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5047 SHERRI ANN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233
Mailing Address - Country:US
Mailing Address - Phone:210-237-4444
Mailing Address - Fax:210-828-0590
Practice Address - Street 1:610 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205
Practice Address - Country:US
Practice Address - Phone:210-237-4444
Practice Address - Fax:210-225-1486
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1076112363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care