Individual
MS. ILONA GOCZA RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
810 S 6TH ST, MONTICELLO, IN 47960-8201
(574) 583-6543
(574) 583-9502
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003456A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000827487
ANTHEM PROVIDE NUMBER
IN
05
—
201022390
—
IN
Enumeration date
02/28/2011
Last updated
02/03/2021
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