Healthcare Provider Details

I. General information

NPI: 1245158062
Provider Name (Legal Business Name): DEVON MARIE GOSNELL CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SENTARA CIR
WILLIAMSBURG VA
23188-5713
US

IV. Provider business mailing address

711 MELROSE WAY
NEWPORT TN
37821-2617
US

V. Phone/Fax

Practice location:
  • Phone: 757-984-6000
  • Fax:
Mailing address:
  • Phone: 828-423-2799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: