Provider Demographics
NPI:1265861835
Name:GELGELU, GOSSAYE (RN)
Entity Type:Individual
Prefix:
First Name:GOSSAYE
Middle Name:
Last Name:GELGELU
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 BARKLEY PL W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2006
Mailing Address - Country:US
Mailing Address - Phone:614-500-1724
Mailing Address - Fax:
Practice Address - Street 1:235 BARKLEY PL W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2006
Practice Address - Country:US
Practice Address - Phone:614-500-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN366276163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse