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General NPI Number Information
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NPI Number | 1164052478
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Entity Type | Individual
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Provider Name | MELLISSA GOSSET FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/26/2020
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Last Update Date | 04/04/2020
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Provider Practice Location Address
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Address Line | 333 SCHOOL ST # 112
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City | PAWTUCKET
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State | RI
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Zip | 02860-5334
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Country | US
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Telephone | 401-726-9790
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Fax |
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Provider Business Mailing Address
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Address Line | 13 AQUIDNECK AVE
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City | PORTSMOUTH
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State | RI
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Zip | 02871-4303
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Country | US
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Telephone | 401-499-7760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN02167
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License Number State | RI
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