Gallo, Bonnie Lou

Gallo, Bonnie Lou is an individual health care provider with primary practice located at 225 Clearfield Ave , Virginia Beach VA 23462-1815. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Gallo, Bonnie Lou can be contacted via phone (757) 457-5480.

Contact Information

Primary practice address
225 Clearfield Ave Virginia Beach VA 23462-1815
Phone: (757) 457-5480
Fax: (757) 819-7481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024107857 Virginia

Profile Details

NPI number 1194772210
LBN Legal business name Gallo, Bonnie Lou
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Nov 23rd, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194772210 NPPES
Virginia Other 10010604N SENTARA
Virginia MEDICAID 101297877 SENTARA

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