Provider Demographics
NPI:1669643508
Name:GAUCHER, ANNE CHRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:CHRISTINE
Last Name:GAUCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2585 HERSCHEL ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4557
Mailing Address - Country:US
Mailing Address - Phone:904-388-2678
Mailing Address - Fax:904-388-6776
Practice Address - Street 1:2585 HERSCHEL ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4557
Practice Address - Country:US
Practice Address - Phone:904-388-2678
Practice Address - Fax:904-388-6776
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9103376363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical