Provider Demographics
NPI:1780932954
Name:GOGOLA, LINDA LEE (RN)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LEE
Last Name:GOGOLA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 SAXONDALE LN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-5762
Mailing Address - Country:US
Mailing Address - Phone:302-678-2154
Mailing Address - Fax:
Practice Address - Street 1:232 SAXONDALE LN
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-5762
Practice Address - Country:US
Practice Address - Phone:302-678-2154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0036130163WH0200X
MI4704154157163WH0200X
PARN352336L163WH0200X
FLRN 2650162163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health