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NPI Code Detail

MEDICARE: KRISTIN E GOSS NP

MEDICARE: KRISTIN E GOSS NP
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
1363L00000XNurse Practitioner71010169AIN
2208VP0014XInterventional Pain Medicine Physician71010169AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578189841
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN E GOSS NP
Provider Business Mailing Address
First Line : 29943 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1299
Country : US
Telephone Number : 317-706-7246
Fax Number :
Provider Business Practice Location Address
First Line : 8805 N MERIDIAN ST STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2643
Country : US
Telephone Number : 317-706-7246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2020
Last Update Date : 11/25/2025

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