Healthcare Provider Details

I. General information

NPI: 1437124898
Provider Name (Legal Business Name): CATHERINE GALLAGHER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 RIDGEWOOD RD
SPRINGFIELD VT
05156
US

IV. Provider business mailing address

107 COURT ST # 310
WATERTOWN NY
13601-2534
US

V. Phone/Fax

Practice location:
  • Phone: 802-885-2151
  • Fax:
Mailing address:
  • Phone: 305-798-7296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number101-0016997
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR028380
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: