| Doctor Name: | VIVIAN B GALLEGOS |
| NPI Number: | 1427317999 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | RN-59707 |
| Business Practice Address: | 233 Main Street Suite C San Luis, CO - 81152 |
| Business Phone Number: | 7196723332 |
| Business Fax Number: | 7196723856 |
| Mailing Address: | Po Box 99, SAN LUIS |
| State: | CO |
| Postal Code: | 811520099 |
| Phone Number: | 7196723332 |
| Fax Number: | 7196723856 |
| NPI Enumeration Date: | 05/03/2012 |
| NPI Last Update Date: | 05/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | RN-59707 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |