Doctor Name: | SUSAN R GOSSELIN |
NPI Number: | 1366721839 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 053956-23 |
Business Practice Address: | 20 Chambers Dr Suite 2200 Hooksett, NH - 031061981 |
Business Phone Number: | 6036415386 |
Business Fax Number: | 6036415387 |
Mailing Address: | 20 Chambers Dr, Suite 2200 HOOKSETT |
State: | NH |
Postal Code: | 031061981 |
Phone Number: | 6036415386 |
Fax Number: | 6036415387 |
NPI Enumeration Date: | 08/15/2011 |
NPI Last Update Date: | 08/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 053956-23 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |