Provider Demographics
NPI:1912262379
Name:GALLAGHER, DONNA M (NP)
Entity type:Individual
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First Name:DONNA
Middle Name:M
Last Name:GALLAGHER
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Gender:F
Credentials:NP
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Mailing Address - Street 1:330 MT AUBURN STREET
Mailing Address - Street 2:WYMAN 3
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02238-5502
Mailing Address - Country:US
Mailing Address - Phone:617-497-9646
Mailing Address - Fax:617-499-5222
Practice Address - Street 1:330 MT AUBURN ST
Practice Address - Street 2:WYMAN 3
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02238
Practice Address - Country:US
Practice Address - Phone:617-497-9646
Practice Address - Fax:617-499-5464
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2016-04-05
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Provider Licenses
StateLicense IDTaxonomies
MA119940363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health