Provider Demographics
NPI:1487057436
Name:GALVAN, MARIA LOURDES (RN, CDE)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LOURDES
Last Name:GALVAN
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:SELLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85634-0548
Mailing Address - Country:US
Mailing Address - Phone:520-383-7332
Mailing Address - Fax:520-383-7343
Practice Address - Street 1:HWY 86 & TOPAWA RD.
Practice Address - Street 2:
Practice Address - City:SELLS
Practice Address - State:AZ
Practice Address - Zip Code:85634-0548
Practice Address - Country:US
Practice Address - Phone:520-383-7332
Practice Address - Fax:520-383-7343
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN146982163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator