Provider Demographics
NPI:1558171173
Name:MCGALLIARD, NAOMI LAW (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:LAW
Last Name:MCGALLIARD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MISS
Other - First Name:NAOMI
Other - Middle Name:CHRISTIANA
Other - Last Name:LAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:110 KELLWOOD DR STE 220A
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-3263
Mailing Address - Country:US
Mailing Address - Phone:478-317-2001
Mailing Address - Fax:
Practice Address - Street 1:110 KELLWOOD DR STE 220A
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-3263
Practice Address - Country:US
Practice Address - Phone:478-317-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN279916363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health