Taris Gonzalez, NP | |
8391 S Shady Trail Dr, Pendleton, IN 46064-8652 | |
(317) 507-2395 | |
Not Available |
Full Name | Taris Gonzalez |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 21 Years |
Location | 8391 S Shady Trail Dr, Pendleton, Indiana |
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 |
---|---|---|---|
1821290743 | NPI | - | NPPES |
P01170026 | Other | IN | RR MEDICARE PTAN |
200460280 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LA2100X | Nurse Practitioner - Acute Care | 71001601 (Indiana) | Secondary |
363L00000X | Nurse Practitioner | 71001601A (Indiana) | Primary |
Entity Name | Gsg Pride Healthcare Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437622701 PECOS PAC ID: 7113267022 Enrollment ID: O20190312002841 |
Mailing Address | Practice Location Address |
---|---|
Taris Gonzalez, NP 8391 S Shady Trail Dr, Pendleton, IN 46064-8652 Ph: (317) 743-0009 | Taris Gonzalez, NP 8391 S Shady Trail Dr, Pendleton, IN 46064-8652 Ph: (317) 507-2395 |
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