# ANNETTE MICHELLE GOLUCKE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1871091876
- **Gender:** F
- **Credential:** CPNP-PC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | CNP03554 | NM | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | AP135944 | TX | — |
| 363LP0200X | Pediatric Nurse Practitioner | CNP-03554 | NM | — |

## Other

- **Enumeration date:** 01/25/2018
- **Last updated:** 12/13/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 49451821 | — | NM |
| 01 | — | 659321YRND | MEDICARE | NM |