Provider Demographics
NPI:1053521112
Name:GOSNELL, AMY LYNETTE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNETTE
Last Name:GOSNELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:LYNETTE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2800 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-7237
Mailing Address - Country:US
Mailing Address - Phone:304-916-0047
Mailing Address - Fax:
Practice Address - Street 1:2610 CAMDEN AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5652
Practice Address - Country:US
Practice Address - Phone:304-917-3739
Practice Address - Fax:304-917-3751
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-26988183500000X
WVRP0006759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist