Provider Demographics
NPI:1609897883
Name:GALEGHER ROSS, CHERYL ADELINE (NP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ADELINE
Last Name:GALEGHER ROSS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ADELINE
Other - Last Name:GALEGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3118 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1342
Mailing Address - Country:US
Mailing Address - Phone:701-280-2486
Mailing Address - Fax:
Practice Address - Street 1:306 4TH ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-4820
Practice Address - Country:US
Practice Address - Phone:218-864-5128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR23332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0280827-22OtherANCC BOARD CERTIFICATION