Goss, Jennifer Lee

Goss, Jennifer Lee is an individual health care provider with primary practice located at 1117 Sunset Dr Suite 104, Grenada MS 38901-4080. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Goss, Jennifer Lee can be contacted via phone (662) 226-0110.

Contact Information

Primary practice address
1117 Sunset Dr Suite 104 Grenada MS 38901-4080
Phone: (662) 226-0110
Fax: (662) 226-3700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R875035 Mississippi

Profile Details

NPI number 1548608128
LBN Legal business name Goss, Jennifer Lee
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2013
Last updated Jun 17th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548608128 NPPES
Mississippi MEDICAID 07501378
Mississippi Other C03154

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