Provider Demographics
NPI:1265132955
Name:CARSON, KATE GALLAHER (RN)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:GALLAHER
Last Name:CARSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LITTLE COLLABAR RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1803
Mailing Address - Country:US
Mailing Address - Phone:914-850-5107
Mailing Address - Fax:
Practice Address - Street 1:50 LITTLE COLLABAR RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1803
Practice Address - Country:US
Practice Address - Phone:914-850-5107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY417293163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health