Healthcare Provider Details

I. General information

NPI: 1649104175
Provider Name (Legal Business Name): AMANDA GOULET APRN-RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E WILLIAMS FIELD RD STE 101
GILBERT AZ
85295-4880
US

IV. Provider business mailing address

920 E WILLIAMS FIELD RD STE 101
GILBERT AZ
85295-4880
US

V. Phone/Fax

Practice location:
  • Phone: 480-499-0201
  • Fax: 480-499-0203
Mailing address:
  • Phone: 480-499-0201
  • Fax: 480-499-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number224127
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: