Healthcare Provider Details
I. General information
NPI: 1801429931
Provider Name (Legal Business Name): MARY GOSHERT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/18/2020
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4020 CONCORD PIKE
WILMINGTON DE
19803-1718
US
IV. Provider business mailing address
4020 CONCORD PIKE
WILMINGTON DE
19803-1718
US
V. Phone/Fax
- Phone: 866-389-2727
- Fax:
- Phone: 866-389-2727
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | L1-0043606 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | LG-0001390 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: