Provider Demographics
NPI:1063223451
Name:GALLAGHER, KATHLEEN HOPE (AGNP-C)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:HOPE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 LEIGH GATE RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4110
Mailing Address - Country:US
Mailing Address - Phone:860-918-2380
Mailing Address - Fax:
Practice Address - Street 1:128 LEIGH GATE RD
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4110
Practice Address - Country:US
Practice Address - Phone:860-918-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program