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General NPI Number Information
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NPI Number | 1770735698
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Entity Type | Individual
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Provider Name | ANITA DENISE GONZALEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 500 LAUCHWOOD DR
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City | LAURINBURG
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State | NC
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Zip | 28352-5599
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Country | US
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Telephone | 910-291-7630
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Fax | 210-291-7635
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Provider Business Mailing Address
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Address Line | 500 LAUCHWOOD DR
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City | LAURINBURG
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State | NC
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Zip | 28352-5599
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Country | US
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Telephone | 910-291-7630
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Fax | 910-291-7635
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-14630
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License Number State | NC
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