Provider Demographics
NPI:1548651029
Name:GOSELAND, AIMEE MARIE (RN, FNP)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:MARIE
Last Name:GOSELAND
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 E BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8342
Mailing Address - Country:US
Mailing Address - Phone:541-842-6413
Mailing Address - Fax:458-225-9637
Practice Address - Street 1:2828 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8342
Practice Address - Country:US
Practice Address - Phone:541-842-6413
Practice Address - Fax:458-225-9637
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201900710163W00000X
CA705588163W00000X
CA95008389363LF0000X
OR201900778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse