NPI 1013763317

Jolene M Gough

Practitioner Personal Care Attendant Kenai, AK

Practice location

Address: 130 S Willow St STE 9, Kenai, AK 99611-9107
Phone: (907) 283-0085

Registered specialties

Personal Care Attendant Primary

Nursing Service Related Providers Taxonomy 3747P1801X Licence 1712359 (AK)

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Registry record

NPI: 1013763317
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Apr 2024
Record last updated: 26 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.