Provider Demographics
NPI:1902424468
Name:GALLAGHER, RACHEL (FNP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 E WASHINGTON AVE APT 713
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-6507
Mailing Address - Country:US
Mailing Address - Phone:602-616-2665
Mailing Address - Fax:
Practice Address - Street 1:822 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-6500
Practice Address - Country:US
Practice Address - Phone:602-616-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10160-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily