Provider Demographics
NPI:1295237527
Name:GOGUEN, ERIKA SHEILA (PA-C)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:SHEILA
Last Name:GOGUEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 DEERWOOD DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1263
Mailing Address - Country:US
Mailing Address - Phone:603-765-3484
Mailing Address - Fax:
Practice Address - Street 1:22 HUNT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4499
Practice Address - Country:US
Practice Address - Phone:603-765-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1348363AM0700X
MAPA6466363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical