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Individual

MR. BRIAN EDWARD GONZALES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5897
(573) 815-8000
(573) 815-2492
Mailing address
810 SHAKERTOWN WAY, COLUMBIA, MO 65203-6048
(314) 495-1237

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2022020263
MO
363LA2200X
Adult Health Nurse Practitioner
2022020263
MO
363LG0600X
Gerontology Nurse Practitioner
2022020263
MO

Other

Enumeration date
08/16/2022
Last updated
08/16/2022
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