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NPI Code Detail

MEDICARE: COLBY ANN GONZALES

MEDICARE: COLBY ANN GONZALES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71011172AIN
2363LF0000XFamily Nurse Practitioner28238646AIN
3363LF0000XFamily Nurse PractitionerRN328554GA

General Provider Information

NPI Number : 1083208524
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLBY ANN GONZALES
Provider Business Mailing Address
First Line : PO BOX 740015
Second Line :
City : ATLANTA
State : GA
Zip : 30374-0015
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 1631 GORDON HWY STE 17A
Second Line :
City : AUGUSTA
State : GA
Zip : 30906-2229
Country : US
Telephone Number : 706-230-7006
Fax Number : 762-257-7442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2021
Last Update Date : 07/01/2024

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Directions to “ COLBY ANN GONZALES ” Practice Location

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