Individual ProviderMaureen F GonzalesNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1520 Sunday Dr, Raleigh, NC 27607-5253(919) 420-1653(919) 782-3456PECOS EnrollmentBased on the most recent information from CMS, provider Maureen F Gonzales does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1891901559Provider TypeIndividualFull NameGonzales, Maureen FCredentialNPGenderFemaleSole ProprietorNoEnumeration Date5/16/2007Last Updated4/1/2021Contact InformationPractice LocationPractice Address1520 Sunday Dr, Raleigh, NC 27607-5253Phone(919) 420-1653FaxUnlisted FaxMailing LocationMailing Address1540 Sunday Dr, Raleigh, NC 27607-6010Phone(919) 782-3456FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LP0200XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense5004821North CarolinaCode363LP0200XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense470South CarolinaProvider IdentifiersIDDescriptionIssuerID7004535DescriptionMedicaidIssuerUnlistedNorth Carolina