Provider Demographics
NPI:1871646448
Name:GATELY, RHONDA LEE (NP)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LEE
Last Name:GATELY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3403
Mailing Address - Country:US
Mailing Address - Phone:508-668-2402
Mailing Address - Fax:
Practice Address - Street 1:111 TORREY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4800
Practice Address - Country:US
Practice Address - Phone:508-586-3800
Practice Address - Fax:508-559-6064
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233806363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health