Provider Demographics
NPI:1437192382
Name:GOSSELIN, PAULETTE T (RNCS)
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:T
Last Name:GOSSELIN
Suffix:
Gender:F
Credentials:RNCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2049
Mailing Address - Country:US
Mailing Address - Phone:207-797-2832
Mailing Address - Fax:207-797-3058
Practice Address - Street 1:134 GRAY RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2049
Practice Address - Country:US
Practice Address - Phone:207-797-2832
Practice Address - Fax:207-797-3058
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014097364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEGONS8006Medicare ID - Type Unspecified