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General NPI Number Information
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NPI Number | 1568414902
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Entity Type | Individual
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Provider Name | PRISCILLA GOOSLIN CFNP
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 306 HOSPITAL DR # 202D
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City | SOUTH WILLIAMSON
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State | KY
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Zip | 41503-4095
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Country | US
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Telephone | 606-237-1516
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Fax | 606-237-4955
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Provider Business Mailing Address
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Address Line | 306 HOSPITAL DR STE 202D
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City | SOUTH WILLIAMSON
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State | KY
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Zip | 41503-4095
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Country | US
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Telephone | 606-237-5800
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 42926
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License Number State | WV
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