Healthcare Provider Details

I. General information

NPI: 1871510701
Provider Name (Legal Business Name): ANN MARIE GOSDIN CPNP- PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

IV. Provider business mailing address

7900 RODEO DR
DENTON TX
76208-2194
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-2068
  • Fax:
Mailing address:
  • Phone: 972-754-3127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number543788
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number543788
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: