Individual
ELLIE GONYEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 BROOKLINE AVE, BOSTON, MA 02215-5403
(518) 681-1569
Mailing address
50 DOVETAIL LN, COTUIT, MA 02635-2550
(518) 681-1569
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2330144
MA
363LF0000X
Family Nurse Practitioner
RN2330144
MA
Other
Enumeration date
06/07/2020
Last updated
10/18/2023
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