COLLEEN L GALLIMORE (NPI# 1346220415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346220415 |
| Entity Type | Individual |
| Full Name | COLLEEN L GALLIMORE |
| Other Name | COLLEEN L WILSON |
| Credential | PAC |
| Practice Address |
3401 W Gore Blvd Lawton OK 73505 |
| Mailing Address |
Po Box 785 Lawton OK 73502 |
| Practice Telephone | 5803574339 |
| Practice Fax Number | 5803574423 |
| Mailing Telephone | 5803579984 |
| Mailing Fax Number | 5803573277 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2008-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
APA1505 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200073860A | 05 |
| Street Address |
3401 W GORE BLVD |
| City | LAWTON |
| State | OK |
| Zip Code | 73505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295735777 | Kathleen Marie Feeley | Nurse Anesthetist, Certified Registered | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2005-07-27 |
| 1437768280 | Jordan Nixon | Speech-Language Pathologist | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-07-28 |
| 1275151953 | Tiffany Fletcher Legako | Speech-Language Pathologist | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-07-09 |
| 1669094371 | Jacob Aaron Fuller | Student in an Organized Health Care Education/Training Program | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-05-15 |
| 1679195614 | Kennan Dale Richards | Student in an Organized Health Care Education/Training Program | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-05-13 |
| 1730701251 | Shelby Madolyn Willis | Student in an Organized Health Care Education/Training Program | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-05-07 |
| 1902427404 | Christopher Raul Fernandez | Student in an Organized Health Care Education/Training Program | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-05-06 |
| 1790305456 | Ethan Jernigan | Student in an Organized Health Care Education/Training Program | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-04-23 |
| 1144840802 | Lyndi Fisher | Student in an Organized Health Care Education/Training Program | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-04-23 |
| 1629607320 | Jordan Renee Price | Student in an Organized Health Care Education/Training Program | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2020-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336779206 | John Nelson Lazenby IIi | Physician Assistant | 4 E Clark Bass Blvd Ste 302, Mcalester, OK 74501-4269 | 2020-01-20 |
| 1578025094 | Shawna Rose Liszewski | Physician Assistant | 6767 S Yale Ave Ste A, Tulsa, OK 74136-3302 | 2019-04-03 |
| 1417418666 | Andrea J Caygill | Physician Assistant | 216 N 20th St, Collinsville, OK 74021-1605 | 2019-03-29 |
| 1093290132 | Nisha Panta | Physician Assistant | 4120 W Memorial Rd # 300, Oklahoma City, OK 73120-9322 | 2018-09-25 |
| 1265920565 | Elite Surgical Assisting, LLC | Physician Assistant | 2924 S 98th East Ave, Tulsa, OK 74129-4407 | 2018-04-23 |
| 1417472259 | Brooke Javon Denton | Physician Assistant | 2924 S. 98th East Ave, Tulsa, OK 74129 | 2017-08-12 |
| 1104216662 | Morgan Hanni | Physician Assistant | 3520 Nw 20th St, Oklahoma City, OK 73107-2818 | 2015-02-04 |
| 1790103455 | A Cut Above Surgical Assisting LLC | Physician Assistant | 6313 E Commercial St, Broken Arrow, OK 74014-6981 | 2014-03-31 |
| 1518204056 | Dustin William Tims | Physician Assistant | 11317 S Western Ave Ste 300, Oklahoma City, OK 73170-5848 | 2013-01-03 |
| 1265797781 | Rebecca Lynn Painter | Physician Assistant | 9915 E 82nd Pl, Tulsa, OK 74133-4557 | 2012-07-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COLLEEN L GALLIMORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.