Kelley Lou Gossage, APNP | |
3860 Monroe Rd, De Pere, WI 54115-8399 | |
(920) 496-4700 | |
(920) 496-4705 |
Full Name | Kelley Lou Gossage |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 26 Years |
Location | 3860 Monroe Rd, De Pere, Wisconsin |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679598023 | NPI | - | NPPES |
43971300 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 87057 (Wisconsin) | Primary |
363L00000X | Nurse Practitioner | 1259 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Vincent Hospital | Green bay, WI | Hospital |
St Mary's Hospital Medical Center | Green bay, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Vincent Hospital-hospital Sisters-third Order Of St Francis | 5799694675 | 546 |
Entity Name | Prevea Clinic Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306869276 PECOS PAC ID: 0042123150 Enrollment ID: O20031106000034 |
Entity Name | St Vincent Hospital-hospital Sisters-third Order Of St Francis |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285613638 PECOS PAC ID: 5799694675 Enrollment ID: O20080620000423 |
Mailing Address | Practice Location Address |
---|---|
Kelley Lou Gossage, APNP Po Box 19070, Prevea Health, Green Bay, WI 54307-9070 Ph: (920) 496-4700 | Kelley Lou Gossage, APNP 3860 Monroe Rd, De Pere, WI 54115-8399 Ph: (920) 496-4700 |
Margaret M Brochocki, APNP PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1325 Angels Path, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-338-0129 | |
Melissa Lynn Jilot, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1881 Chicago St, De Pere, WI 54115 Phone: 920-403-8000 Fax: 920-433-6009 | |
Paul Antonissen, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3957 Garrett St, De Pere, WI 54115 Phone: 920-471-3729 | |
Aspen Marie Jump, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1325 Angels Path, De Pere, WI 54115 Phone: 920-338-2855 | |
Rachel Ann Mcgill, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 465 Winding Waters Way, De Pere, WI 54115 Phone: 920-621-6703 | |
Ivy E Leasum, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 320 N Wisconsin St, De Pere, WI 54115 Phone: 920-327-7056 | |
Pamela M Page, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700 |