Individual
MS. DOROTHY A. GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
VIRTUA AND DUPONT CHILDRENS HEALTH PROGRAM, 1000 WHITE HORSE ROAD SUITE 204, VOORHEES, NJ 08043-4406
(856) 309-8508
(856) 309-8556
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NR05622800
NJ
363LP0200X
Pediatric Nurse Practitioner
NR05622800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22616
—
NJ
05
—
4040228
—
MD
Enumeration date
10/13/2006
Last updated
04/25/2016
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