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General NPI Number Information
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NPI Number | 1457235848
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Entity Type | Individual
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Provider Name | ANNA ARLENE GOOSSEN PA
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 710 N WALNUT ST
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City | MEDICINE LODGE
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State | KS
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Zip | 67104-1019
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Country | US
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Telephone | 620-886-3771
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Fax |
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Provider Business Mailing Address
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Address Line | 15571 SE 160 AVE
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City | NORWICH
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State | KS
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Zip | 67118-9009
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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