1952359762 NPI number — ANNABEL GALVA MD

Table of content: ANNABEL GALVA MD (NPI 1952359762)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952359762 NPI number — ANNABEL GALVA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALVA
Provider First Name:
ANNABEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952359762
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14301 FNB PKWY STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68154-7200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-758-5233
Provider Business Mailing Address Fax Number:
888-972-1672

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
933 E PIERCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COUNCIL BLUFFS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51503-4626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-361-5225
Provider Business Practice Location Address Fax Number:
402-391-1533
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  34530 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 21642 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4548917 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97054 . This is a "WELLMARK" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10025173600 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1603163 . This is a "UHC AMERICHOICE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1603184 . This is a "UHC SHARE ADVANTAGE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 22260 . This is a "WELLMARK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 236691 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com