Provider Demographics
NPI:1689905952
Name:GONZALEZ, EDWARD JOSEPH (FNP-C)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:JOSEPH
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:EDWARD
Other - Middle Name:JOSEPH
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:36662 VEILED ST
Mailing Address - Street 2:
Mailing Address - City:ANCHOR POINT
Mailing Address - State:AK
Mailing Address - Zip Code:99556-9123
Mailing Address - Country:US
Mailing Address - Phone:907-987-5830
Mailing Address - Fax:
Practice Address - Street 1:3004 ORANGE GROVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-715-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK24080163WE0003X
VI200019363LF0000X
AK1399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency