Healthcare Provider Details

I. General information

NPI: 1952298770
Provider Name (Legal Business Name): NICOLETTE E DRAGONY-GOFF APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLETTE DRAGONY FNP

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 N JASPER DR STE 3
FLAGSTAFF AZ
86001-1632
US

IV. Provider business mailing address

1497 W UNIVERSITY HEIGHTS DR N
FLAGSTAFF AZ
86005-8971
US

V. Phone/Fax

Practice location:
  • Phone: 928-913-8800
  • Fax:
Mailing address:
  • Phone: 707-334-3626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number325730
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number325730
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: