Individual
LINDSAY K GOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7910 W JEFFERSON BLVD STE 108, FORT WAYNE, IN 46804-4159
(260) 436-0800
Mailing address
6610 MUTUAL DR, FORT WAYNE, IN 46825-4236
(260) 436-0800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012681A
IN
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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