| Ashley Gallup, | |
|
2817 Se 91st St, Moore, OK 73160-9123 | |
| (405) 371-5729 | |
| Not Available |
| Full Name | Ashley Gallup |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 2817 Se 91st St, Moore, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407205347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WC0200X | Registered Nurse - Critical Care Medicine | R0101320 (Oklahoma) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 101320 (Oklahoma) | Primary |
| Entity Name | Board Of Regents Of The University Of Oklahoma - Ou Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801869250 PECOS PAC ID: 2860304334 Enrollment ID: O20031103000607 |
| Entity Name | Digestive Disease Specialists Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366489213 PECOS PAC ID: 7315939279 Enrollment ID: O20040331001151 |
| Entity Name | Ou Health Partners Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528642642 PECOS PAC ID: 5991105876 Enrollment ID: O20210615000618 |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Gallup, 2817 Se 91st St, Moore, OK 73160-9123 Ph: (405) 371-5729 | Ashley Gallup, 2817 Se 91st St, Moore, OK 73160-9123 Ph: (405) 371-5729 |
Jessica Renae Garrett, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2800 Se 11th St, Moore, OK 73160 Phone: 405-618-2272 |