Provider Demographics
NPI:1992499933
Name:GOSSAGE, CIERA RENEE (CIERA GOSSAGE, RN)
Entity type:Individual
Prefix:MS
First Name:CIERA
Middle Name:RENEE
Last Name:GOSSAGE
Suffix:
Gender:F
Credentials:CIERA GOSSAGE, RN
Other - Prefix:MS
Other - First Name:CIERA
Other - Middle Name:RENEE
Other - Last Name:GOSSAGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CIERA GOSSAGE, RN
Mailing Address - Street 1:600 S WHITEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-8422
Mailing Address - Country:US
Mailing Address - Phone:712-420-5036
Mailing Address - Fax:
Practice Address - Street 1:1600 DIAMOND ST
Practice Address - Street 2:
Practice Address - City:ONAWA
Practice Address - State:IA
Practice Address - Zip Code:51040-1548
Practice Address - Country:US
Practice Address - Phone:712-423-2311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA161540163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse