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NPI Code Detail

MEDICARE: JESSIE STRENGTH GOULD ACNPC-AG

MEDICARE:   JESSIE STRENGTH GOULD  ACNPC-AG
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
1363LA2100XAcute Care Nurse Practitioner220400AZ

General Provider Information

NPI Number : 1710679931
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSIE STRENGTH GOULD ACNPC-AG
Provider Business Mailing Address
First Line : 3987 N ZURICH ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-2254
Country : US
Telephone Number : 601-624-2285
Fax Number :
Provider Business Practice Location Address
First Line : 2201 N VICKEY ST STE 110
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-6126
Country : US
Telephone Number : 928-213-9460
Fax Number : 928-213-9465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2023
Last Update Date : 12/03/2025

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Directions to “ JESSIE STRENGTH GOULD ACNPC-AG” Practice Location

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