Gossage, Kelley Lou

Gossage, Kelley Lou is an individual health care provider with primary practice located at 3860 Monroe Rd , De Pere WI 54115-8399. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Nursing Service Providers / Registered Nurse is her primary health care specialty. Gossage, Kelley Lou can be contacted via phone (920) 496-4700.

Contact Information

Primary practice address
3860 Monroe Rd De Pere WI 54115-8399
Phone: (920) 496-4700
Fax: (920) 496-4705
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 87057 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1259 Wisconsin

Profile Details

NPI number 1679598023
LBN Legal business name Gossage, Kelley Lou
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679598023 NPPES
Wisconsin MEDICAID 43971300

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