Individual
NANCY J GONSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5277
(605) 945-5295
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5277
(605) 945-5295
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0220
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6820210
—
SD
Enumeration date
06/01/2006
Last updated
04/13/2012
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