Individual
CHANTAL MARIE GOUGEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
15515 KENDALL CREEK RD, CLINTON, MT 59825-9708
(702) 466-2495
Mailing address
8121 BEAR CLAN CT, LAS VEGAS, NV 89131-1455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NUR-APRN-LIC-218334
MT
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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