Individual
RANDALL A GOSSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
975 E THIRD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN125555
GA
163W00000X
Registered Nurse
RN73691
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN9404
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000680886A
—
GA
05
—
009804700
—
AL
01
—
3040256
BLUE CROSS BLUE SHIELD TN
TN
05
—
3622512
—
TN
01
—
430030821
RAILROAD MEDICARE
TN
05
—
8052084
—
NC
01
—
N410924
WELLCARE (GA MEDICAID)
GA
Enumeration date
12/04/2006
Last updated
01/26/2010
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