Individual
JESSICA DALE GOSSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
225 MEDICAL CENTER DR STE 308, PADUCAH, KY 42003-7915
(270) 443-0777
Mailing address
225 MEDICAL CENTER DR STE 308, PADUCAH, KY 42003-7915
(270) 443-0777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012939
KY
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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