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NPI Code Detail

MEDICARE: MARTHA ANN GOODFRIEND RN,BSN, M.ED.

MEDICARE: MARTHA ANN GOODFRIEND RN,BSN, M.ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse161905OH

General Provider Information

NPI Number : 1528789286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA ANN GOODFRIEND RN,BSN, M.ED.
Provider Business Mailing Address
First Line : 7080 LEIBEL RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-2812
Country : US
Telephone Number : 513-257-1567
Fax Number :
Provider Business Practice Location Address
First Line : 7080 LEIBEL RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-2812
Country : US
Telephone Number : 513-257-1567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2022
Last Update Date : 09/09/2022

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