Provider Demographics
NPI:1013020734
Name:GONSIOROSKI, LAUNA M (ANP)
Entity Type:Individual
Prefix:MS
First Name:LAUNA
Middle Name:M
Last Name:GONSIOROSKI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 GRIFFIN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:ME
Mailing Address - Zip Code:04757
Mailing Address - Country:US
Mailing Address - Phone:207-764-8026
Mailing Address - Fax:
Practice Address - Street 1:163 VAN BUREN RD
Practice Address - Street 2:- VA CLINIC
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736
Practice Address - Country:US
Practice Address - Phone:207-498-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER024702363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health