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General NPI Number Information
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NPI Number | 1992668917
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Entity Type | Individual
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Provider Name | ANTOINETTE NICOLE GOOSBY CRNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 3030 GREENMOUNT AVE STE 300 PMB 187623
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City | BALTIMORE
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State | MD
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Zip | 21218-6907
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Country | US
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Telephone | 301-679-7488
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Fax | 301-235-1580
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Provider Business Mailing Address
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Address Line | 3030 GREENMOUNT AVE STE 300 PMB 187623
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City | BALTIMORE
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State | MD
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Zip | 21218-6907
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Country | US
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Telephone | 301-679-7488
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Fax | 301-235-1580
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 408135
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License Number State | NY
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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 | R248982
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License Number State | MD
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