Individual
MRS. LORRAINE ANN GOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 CAMINO DEL SOL ST., CORALES, NM 87048
(505) 792-1516
Mailing address
PO BOX 1860, CORRALES, NM 87048-1860
(505) 792-1516
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R14606
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S6061
—
NM
Enumeration date
05/14/2007
Last updated
07/08/2007
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