Individual
MRS. BRANDY GOOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
805 WEST KANSAS, JAL, NM 88252
(575) 395-3400
(575) 395-2781
Mailing address
327 DEEP WELLS RD, JAL, NM 88252-9724
(575) 395-2495
(888) 430-7095
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP01280
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8L6663
MEDICARE PTAN
—
Enumeration date
09/17/2008
Last updated
12/09/2010
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