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Individual
SHELLEY NICOLE GOUGH
Active
Individual
SHELLEY NICOLE GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28194797A
IN
363LF0000X
Family Nurse Practitioner
Primary
71010755A
IN
Other
Enumeration date
12/30/2020
Last updated
06/13/2024
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