Provider Demographics
NPI:1386321636
Name:GALLINA, VICTORIA RENEE (DNP, AGACNP)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:RENEE
Last Name:GALLINA
Suffix:
Gender:F
Credentials:DNP, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9103 FRANKLIN SQUARE DR STE 302
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3939
Mailing Address - Country:US
Mailing Address - Phone:443-777-8807
Mailing Address - Fax:
Practice Address - Street 1:9103 FRANKLIN SQUARE DR STE 302
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3939
Practice Address - Country:US
Practice Address - Phone:443-777-8807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2023062527363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care