Provider Demographics
NPI:1306143219
Name:GOSS, ALEXIS PIERINO (PA-C)
Entity type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:PIERINO
Last Name:GOSS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 HEART DRIVE MAILSTOP 654
Practice Address - Street 2:ECU PHYSICIANS FAMILY MEDICINE
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-4611
Practice Address - Fax:252-744-2056
Is Sole Proprietor?:No
Enumeration Date:2011-02-13
Last Update Date:2021-08-23
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Provider Licenses
StateLicense IDTaxonomies
NC001002753363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2762699Medicare PIN