Healthcare Provider Details

I. General information

NPI: 1548756505
Provider Name (Legal Business Name): ARICA LYNNE GOGOL NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 W CENTRAL AVE STE D
TOLEDO OH
43606-3859
US

IV. Provider business mailing address

166 LAWAI RD
OREGON OH
43616-2522
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-2192
  • Fax:
Mailing address:
  • Phone: 419-290-8612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License NumberAPRN.CNM.0019653
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024176261
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0037562
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: