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Individual

DAVID N GOSSELIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
305 PINEVIEW DR, WAYCROSS, GA 31501-5229
(912) 283-7118
(912) 283-7132
Mailing address
305 PINEVIEW DR, WAYCROSS, GA 31501-5229
(912) 283-7118
(912) 283-7132

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
ARNP3174172
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
RN230020
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20-4363143
ORTHOPEDIC SURGERY AND SPORTS MEDICINE-MAYO CLINIC HEALTH SYSTEM WAYCROSS
GA
Enumeration date
07/17/2013
Last updated
07/17/2013
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