Provider Demographics
NPI:1831506922
Name:GALLOWAY, KIMBERLI (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLI
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 WINDING CREEK CT
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1075
Mailing Address - Country:US
Mailing Address - Phone:307-771-3867
Mailing Address - Fax:
Practice Address - Street 1:127 WINDING CREEK CT
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-1075
Practice Address - Country:US
Practice Address - Phone:307-771-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA803891163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health