Caryn Sue Gonzales, ANP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

858 Issued in AK

Practice address

16720 E Maud Rd
Palmer, AK 99645-7520

Phone

(907) 631-3684

Fax

(907) 707-1212

NPI assigned

Nov 10, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1376524967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2649",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996452649",
            "telephone_number": "907-631-3684",
            "fax_number": "907-707-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16720 E MAUD RD",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457520",
            "telephone_number": "907-631-3684",
            "fax_number": "907-707-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "CARYN",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "858",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "858",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022580",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Gilliland, OTR
• Glacier Surgical Associates, Inc
• Melinda H. Glass, PH.D.
• Tracy Glatz
• Samantha Ann Glick-Maccracken
• Erica Gonzalez, LPC
• Sylvia Gonzalez
• Teresa Gool
• Heather Gora, RN
• Elena Gorovaya

• Psychiatric/Mental Health Nurse Practitioner in Palmer, AK
• Providers in Palmer, AK by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.