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Individual
ANNETTE MICHELLE GOLUCKE
Active
Individual
ANNETTE MICHELLE GOLUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP03554
NM
363LP0200X
Pediatric Nurse Practitioner
AP135944
TX
363LP0200X
Pediatric Nurse Practitioner
CNP-03554
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49451821
—
NM
01
—
659321YRND
MEDICARE
NM
Enumeration date
01/25/2018
Last updated
12/13/2021
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