Individual ProviderKaitlyn GossardPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address11220 Elm Ln Ste 102, Charlotte, NC 28277-0716(704) 847-4000(704) 983-3855PECOS EnrollmentBased on the most recent information from CMS, provider Kaitlyn Gossard is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1336821834Provider TypeIndividualFull NameGossard, KaitlynCredentialPA-CGenderFemaleSole ProprietorYesEnumeration Date8/3/2023Last Updated11/1/2024Contact InformationPractice LocationPractice Address11220 Elm Ln Ste 102, Charlotte, NC 28277-0716Phone(704) 847-4000Fax(704) 847-4001Mailing LocationMailing Address1908 Hilco St Ste B, Albemarle, NC 28001-6388Phone(704) 983-3855FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerNorth Carolina