Individual
MRS. JENNY VANLORA GOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1105 BURLEYSON RD, DALTON, GA 30720-3181
(706) 278-4640
(706) 275-6599
Mailing address
105 JW PLAZA DR SE STE 1, CALHOUN, GA 30701-1503
(706) 383-5622
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
114271-30
WI
367A00000X
Advanced Practice Midwife
Primary
RN261026
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003180417B
—
GA
Enumeration date
01/03/2014
Last updated
10/04/2021
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