Individual
ASHLEY RENAE GOMULKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.431607
IL
363L00000X
Nurse Practitioner
Primary
209021834
IL
363LF0000X
Family Nurse Practitioner
209.021834
IL
Other
Enumeration date
09/08/2020
Last updated
03/04/2024
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