Basic Information
| Provider Information | |||||||||
| NPI: | 1932231180 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GALLOWAY | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | CLAYTON | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 SAUNDERSVILLE ROAD | ||||||||
| Address2: | 160 | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158243737 | ||||||||
| FaxNumber: | 8886876133 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 PATTERSON STREET | ||||||||
| Address2: | 217 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158843737 | ||||||||
| FaxNumber: | 8886876133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2007 | ||||||||
| LastUpdateDate: | 09/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA 1352 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 208VP0000X | PA1352 | TN | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 7100242880 | 05 | KY | MEDICAID | 1523574 | 05 | TN | MEDICAID |