Individual
POLLY SUE GOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1535 HIGHLANDS DR STE 100, LITITZ, PA 17543-7681
(717) 627-4088
(717) 627-4089
Mailing address
409 S 2ND ST STE 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP010356
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024288560002
—
PA
Enumeration date
07/24/2009
Last updated
06/30/2017
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