Provider Demographics
NPI:1467347161
Name:GALLOWITZ, KENDALL
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:GALLOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5807 STATE ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-8991
Mailing Address - Country:US
Mailing Address - Phone:513-316-9909
Mailing Address - Fax:
Practice Address - Street 1:230 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:SEAMAN
Practice Address - State:OH
Practice Address - Zip Code:45679-8002
Practice Address - Country:US
Practice Address - Phone:937-386-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0039422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily