Provider Demographics
NPI:1568268167
Name:GALLOWAY, SHEREEN A
Entity type:Individual
Prefix:MS
First Name:SHEREEN
Middle Name:A
Last Name:GALLOWAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 FIDDLESTICKS DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-6713
Mailing Address - Country:US
Mailing Address - Phone:407-946-4626
Mailing Address - Fax:
Practice Address - Street 1:658 FIDDLESTICKS DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-6713
Practice Address - Country:US
Practice Address - Phone:407-946-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9449392163W00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No163W00000XNursing Service ProvidersRegistered Nurse