Mrs Jenny Vanlora Goss, CNM | |
1105 Burleyson Rd, Dalton, GA 30720-3181 | |
(706) 278-4640 | |
(706) 275-6599 |
Full Name | Mrs Jenny Vanlora Goss |
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Gender | Female |
Speciality | Advanced Practice Midwife |
Location | 1105 Burleyson Rd, Dalton, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578984811 | NPI | - | NPPES |
003180417B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163WH0200X | Registered Nurse - Home Health | 114271-30 (Wisconsin) | Secondary |
367A00000X | Advanced Practice Midwife | RN261026 (Georgia) | Primary |
Entity Name | Andalusia Physician Practices Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437202009 PECOS PAC ID: 7315043007 Enrollment ID: O20070425000603 |
Mailing Address | Practice Location Address |
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Mrs Jenny Vanlora Goss, CNM 105 Jw Plaza Dr Se Ste 1, Calhoun, GA 30701-1503 Ph: (706) 383-5622 | Mrs Jenny Vanlora Goss, CNM 1105 Burleyson Rd, Dalton, GA 30720-3181 Ph: (706) 278-4640 |
Ms. Sanna Rose Wagner, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 1525 Chattanooga Rd, Dalton, GA 30720 Phone: 706-226-3373 Fax: 706-226-0845 | |
Mrs. Susan Cockburn, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 1105 Burleyson Rd, Dalton, GA 30720 Phone: 706-278-4640 Fax: 706-275-6599 | |
Elizabeth Jean Day, C.N.M. Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 1525 Chattanooga Rd, Dalton, GA 30720 Phone: 706-226-3373 Fax: 706-226-0845 | |
Nichole Nguyen, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 1105 Burleyson Rd, Dalton, GA 30720 Phone: 706-278-4640 | |
Lauren Elizabeth Banaszak, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 1105 Burleyson Rd, Dalton, GA 30720 Phone: 706-278-4640 | |
Mrs. Joellen Wingate, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 1105 Burleyson Rd, Dalton, GA 30720 Phone: 706-278-4640 Fax: 706-275-6599 | |
Amy Elizabeth Van Orden, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 1525 Chattanooga Rd, Dalton, GA 30720 Phone: 706-226-3373 Fax: 706-226-4256 |