Provider Demographics
NPI:1699369660
Name:GOSNELL, ANA (NP)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:GOSNELL
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7227
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-7227
Mailing Address - Country:US
Mailing Address - Phone:803-224-9212
Mailing Address - Fax:803-470-4715
Practice Address - Street 1:101 MEDICAL CIR STE A
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3650
Practice Address - Country:US
Practice Address - Phone:803-244-9212
Practice Address - Fax:803-708-0865
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC24454A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care