Individual
MICHELE LYNN GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP2160
AZ
363LF0000X
Family Nurse Practitioner
AP2160
AZ
Other
Enumeration date
08/02/2005
Last updated
09/08/2020
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