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NPI Code Detail

MEDICARE: MADISON GOHLKE RN

MEDICARE:   MADISON  GOHLKE  RN
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
1163WP2201XAmbulatory Care Registered Nurse1054493TX

General Provider Information

NPI Number : 1508709213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON GOHLKE RN
Provider Business Mailing Address
First Line : 4708 ALLIANCE BLVD STE 700
Second Line :
City : PLANO
State : TX
Zip : 75093-5317
Country : US
Telephone Number : 496-814-4865
Fax Number :
Provider Business Practice Location Address
First Line : 4708 ALLIANCE BLVD STE 700
Second Line :
City : PLANO
State : TX
Zip : 75093-5317
Country : US
Telephone Number : 496-814-4865
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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