Provider Demographics
NPI:1942736590
Name:GAGLIAS, KATE
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:GAGLIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-4415
Mailing Address - Country:US
Mailing Address - Phone:631-532-9180
Mailing Address - Fax:
Practice Address - Street 1:5659 NC-11 S
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:NC
Practice Address - Zip Code:27812
Practice Address - Country:US
Practice Address - Phone:252-825-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program