Healthcare Provider Details

I. General information

NPI: 1528155975
Provider Name (Legal Business Name): PATRICIA ANN GOULD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 FRANKLIN SQUARE DR
BALTIMORE MD
21237-3903
US

IV. Provider business mailing address

2229 VAILTHORN RD
BALTIMORE MD
21220-4936
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-3725
  • Fax: 410-887-8473
Mailing address:
  • Phone: 410-687-3534
  • Fax: 410-887-0265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR043449
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: