Provider Demographics
NPI:1215225784
Name:GOSHORN, BARBARA GAMBLE (RN, MSACN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:GAMBLE
Last Name:GOSHORN
Suffix:
Gender:F
Credentials:RN, MSACN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2450
Mailing Address - Country:US
Mailing Address - Phone:585-671-0934
Mailing Address - Fax:585-971-9082
Practice Address - Street 1:725 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2450
Practice Address - Country:US
Practice Address - Phone:585-671-0934
Practice Address - Fax:585-971-9082
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY379878-1133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education