Individual
KELLY C GOCLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP-AC
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3300
Mailing address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704251278
MI
363LP0200X
Pediatric Nurse Practitioner
Primary
36415
TN
363LP0200X
Pediatric Nurse Practitioner
4704251278
MI
Other
Enumeration date
09/07/2023
Last updated
08/13/2024
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