MEDICARE: MS. CHRISTINA N GOSS WHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN0000133438	TN
2	363LW0102X	Women's Health Nurse Practitioner	APN0000010431	TN
3	363L00000X	Nurse Practitioner	10431	TN
4	163W00000X	Registered Nurse	133438	TN

General Provider Information

NPI Number	:	1083747703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA N GOSS WHNP-BC

Provider Business Mailing Address
First Line	:	1924 ALCOA HWY 6 SOUTH
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920
Country	:	US
Telephone Number	:	865-305-8888
Fax Number	:	865-305-6180

Provider Business Practice Location Address
First Line	:	1924 ALCOA HWY 6 SOUTH
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920
Country	:	US
Telephone Number	:	865-305-8888
Fax Number	:	865-305-6180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	06/28/2013

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