Individual provider · Type 1 NPI

Stephanie Lane Gallegos, P.A.-C

Medical Physician Assistant · Richmond, VA

NPI number 1104051960 Active

Practice location

1501 Maple Ave, Suite 200 NW Mob
Richmond, VA 23226-2553

Call (804) 285-2300 Map

Fax (804) 285-8420

Mailing address

PO Box 71690
Richmond, VA 23255-1690

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XPA-082 (NM)
Medical Physician Assistant Primary 363AM0700X0110004398 (VA)

Medical Physician Assistant: Definition to come...

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About NPI 1104051960

Stephanie Lane Gallegos, P.A.-C's National Provider Identifier is 1104051960, issued on May 22, 2009. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Richmond, VA. The record was last updated on Apr 19, 2016.