Individual
COREY LANE GOSNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
175 KIMEL PARK DR STE 100, WINSTON SALEM, NC 27103-6951
(336) 718-3550
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-3550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11711
NC
Other
Enumeration date
09/14/2021
Last updated
02/03/2022
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