MEDICARE: MS. LELA B GOULD CRNP

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	SP013530	PA

General Provider Information

NPI Number	:	1942621040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LELA B GOULD CRNP

Provider Business Mailing Address
First Line	:	9 N. BROOKSIDE ROAD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-2527
Country	:	US
Telephone Number	:	610-543-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 N. BROOKSIDE ROAD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-2527
Country	:	US
Telephone Number	:	610-543-5400
Fax Number	:

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

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	03/23/2025

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