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General NPI Number Information
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NPI Number | 1528069531
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Entity Type | Individual
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Provider Name | MISTY R GOLDSON PMHNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 02/22/2025
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Provider Practice Location Address
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Address Line | 600 MONTICELLO ST STE 1
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City | SOMERSET
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State | KY
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Zip | 42501-2974
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Country | US
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Telephone | 606-400-2227
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Fax | 606-332-0576
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Provider Business Mailing Address
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Address Line | PO BOX 142
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City | BURNSIDE
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State | KY
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Zip | 42519-0142
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Country | US
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Telephone | 606-400-2227
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Fax | 606-332-0576
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3004253
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3004253
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License Number State | KY
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