Gallagher, Jacqueline
Gallagher, Jacqueline is an individual health care provider with primary practice located at 130 Fisher Rd Emergency Dept, Berlin VT 05602-9516. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Gallagher, Jacqueline can be contacted via phone (802) 371-4365.Contact Information
Primary practice address
130 Fisher Rd Emergency Dept
Berlin VT 05602-9516
Phone: (802) 371-4365
Fax: (802) 371-4481
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 586 | Massachusetts |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 055.0031114 | Vermont |
Profile Details
| NPI number | 1063470557 |
|---|---|
| LBN Legal business name | Gallagher, Jacqueline |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Dec 15th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063470557 | NPPES |
| Vermont | MEDICAID | 9000545 |
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