Individual
MICKIE LYNN GOCKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
8 N E ST, LAKEVIEW, OR 97630-1524
(320) 241-5465
Mailing address
8 N E ST, LAKEVIEW, OR 97630-1524
(320) 241-5465
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
10043127
OR
363LG0600X
Gerontology Nurse Practitioner
IP61550574
WA
Other
Enumeration date
10/30/2024
Last updated
05/14/2025
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