Healthcare Provider Details

I. General information

NPI: 1407376874
Provider Name (Legal Business Name): ERIN GOSNELL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN JONES

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FORD RD
JOHN DAY OR
97845-2009
US

IV. Provider business mailing address

170 FORD RD
JOHN DAY OR
97845-2009
US

V. Phone/Fax

Practice location:
  • Phone: 541-575-0404
  • Fax:
Mailing address:
  • Phone: 541-575-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10063560
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: