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NPI Code Detail

MEDICARE: COURTNEY F GOUGE

MEDICARE: COURTNEY F GOUGE
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
1390200000XStudent in an Organized Health Care Education/Training ProgramRN.518217OH

General Provider Information

NPI Number : 1689507378
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY F GOUGE
Provider Business Mailing Address
First Line : 477 WALFIELD DR
Second Line :
City : MANSFIELD
State : OH
Zip : 44904-1647
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10900 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1712
Country : US
Telephone Number : 216-368-6459
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ COURTNEY F GOUGE ” Practice Location

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