Provider Demographics
NPI:1487039996
Name:GOULD, BETTY ANN (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:ANN
Last Name:GOULD
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E 680 S
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3593
Mailing Address - Country:US
Mailing Address - Phone:435-865-1387
Mailing Address - Fax:435-586-5103
Practice Address - Street 1:245 E 680 S
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3593
Practice Address - Country:US
Practice Address - Phone:435-865-1387
Practice Address - Fax:435-586-5103
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-26
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5158098-3102163W00000X
UT5158098-4405363LF0000X
CA318108163W00000X
NVRN63613163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse