Provider Demographics
NPI:1598519373
Name:GOSSETT, CASEY MARIE RAINS (CRNP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:MARIE RAINS
Last Name:GOSSETT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 COUNTY ROAD 13
Mailing Address - Street 2:
Mailing Address - City:CENTRE
Mailing Address - State:AL
Mailing Address - Zip Code:35960-5502
Mailing Address - Country:US
Mailing Address - Phone:256-557-2630
Mailing Address - Fax:
Practice Address - Street 1:2820 AL HIGHWAY 68 W
Practice Address - Street 2:
Practice Address - City:SANDROCK
Practice Address - State:AL
Practice Address - Zip Code:35983-4200
Practice Address - Country:US
Practice Address - Phone:362-725-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP002231363LF0000X
AL1-155305363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily