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NPI Code Detail

MEDICARE: MRS. HOLLY E GOSSETT PA-C

MEDICARE: MRS. HOLLY E GOSSETT PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA9104509FL
2363A00000XPhysician Assistant0010-06470NC
3363A00000XPhysician Assistant009245GA

General Provider Information

NPI Number : 1437329950
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY E GOSSETT PA-C
Provider Business Mailing Address
First Line : 55 WHITCHER ST NE STE 350
Second Line :
City : MARIETTA
State : GA
Zip : 30060-1129
Country : US
Telephone Number : 770-424-6893
Fax Number :
Provider Business Practice Location Address
First Line : 55 WHITCHER ST NE STE 350
Second Line :
City : MARIETTA
State : GA
Zip : 30060-1129
Country : US
Telephone Number : 770-424-6893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2008
Last Update Date : 07/27/2020

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Directions to “ MRS. HOLLY E GOSSETT PA-C” Practice Location

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