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Individual

JUDITH ANN GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
100 FAIRFIELD DR, SENECA, PA 16346-2130
(814) 676-7843
(814) 676-7838
Mailing address
PO BOX 2585, COLUMBUS, GA 31902-2585
(706) 660-8505
(706) 660-9390

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN132769L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0015509530025
MEDICAID GROUP
PA
05
1015496050001
PA
01
808862
MEDICARE GROUP
PA
Enumeration date
11/29/2005
Last updated
01/29/2012
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