MEDICARE: PAULA GONZALEZ NP

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
1	363LF0000X	Family Nurse Practitioner	221316	AR

General Provider Information

NPI Number	:	1407584527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA GONZALEZ NP

Provider Business Mailing Address
First Line	:	131 PEBBLE BEACH DR
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-2233
Country	:	US
Telephone Number	:	501-282-8380
Fax Number	:

Provider Business Practice Location Address
First Line	:	3426 CENTRAL AVE
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6277
Country	:	US
Telephone Number	:	501-431-0175
Fax Number	:	501-431-0176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	05/11/2024

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