Rhonda Jo Gola, FNP | |
930 Blue Star Hwy, South Haven, MI 49090-7758 | |
(269) 637-1115 | |
Not Available |
Full Name | Rhonda Jo Gola |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 930 Blue Star Hwy, South Haven, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003555368 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 4704383606 (Michigan) | Primary |
Entity Name | Bronson Lakeview Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235131137 PECOS PAC ID: 9032008495 Enrollment ID: O20051027001022 |
Mailing Address | Practice Location Address |
---|---|
Rhonda Jo Gola, FNP 601 John Street, Box 39, Kalamazoo, MI 49007-9438 Ph: () - | Rhonda Jo Gola, FNP 930 Blue Star Hwy, South Haven, MI 49090-7758 Ph: (269) 637-1115 |
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