Individual
KATHRYN GOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1161 CHURCH ROAD W, SOUTHAVEN, MS 38671-7144
(662) 253-1067
(662) 253-1068
Mailing address
PO BOX 306415, NASHVILLE, TN 37230-6415
(931) 253-1110
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905946
MS
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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