Provider Demographics
NPI:1043476740
Name:GALLINARO, PHILIP MICHAEL (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:MICHAEL
Last Name:GALLINARO
Suffix:
Gender:
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9183 W FLAMINGO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6464
Mailing Address - Country:US
Mailing Address - Phone:602-653-7816
Mailing Address - Fax:702-975-9292
Practice Address - Street 1:8572 W PURDUE AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-5349
Practice Address - Country:US
Practice Address - Phone:602-653-7816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2025-04-09
Deactivation Date:2024-06-11
Deactivation Code:
Reactivation Date:2024-06-28
Provider Licenses
StateLicense IDTaxonomies
343900000X
NV868097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)