Individual
MAUREEN F GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1520 SUNDAY DR, RALEIGH, NC 27607-5253
(919) 420-1653
Mailing address
1540 SUNDAY DR, RALEIGH, NC 27607-6010
(919) 782-3456
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
470
SC
363LP0200X
Pediatric Nurse Practitioner
Primary
5004821
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004535
—
NC
Enumeration date
05/16/2007
Last updated
04/01/2021
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