Gould, Wallena M

Gould, Wallena M is an individual health care provider with primary practice located at 1505 W Sherman Ave , Vineland NJ 08360-6912. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Gould, Wallena M can be contacted via phone (856) 641-8000.

Contact Information

Primary practice address
1505 W Sherman Ave Vineland NJ 08360-6912
Phone: (856) 641-8000
Fax: (856) 641-7668
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 26NJ00243400 New Jersey
Nursing Service Providers / Registered Nurse 163W00000X 26NR08657200 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN502167L Pennsylvania

Profile Details

NPI number 1588674717
LBN Legal business name Gould, Wallena M
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Sep 5th, 2012 - about 13 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 1588674717 NPPES
Pennsylvania MEDICAID 102332049
Pennsylvania Other 072989
Pennsylvania Other P00795663

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