Healthcare Provider Details

I. General information

NPI: 1386834273
Provider Name (Legal Business Name): SHIRLEY H GOFF APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 CHURCH ST STE 101
PIKEVILLE KY
41501-3476
US

IV. Provider business mailing address

PO BOX 1433
PIKEVILLE KY
41502-1433
US

V. Phone/Fax

Practice location:
  • Phone: 606-218-6011
  • Fax: 606-218-6082
Mailing address:
  • Phone: 606-218-6011
  • Fax: 606-218-6082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3005049
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3005049
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number5049S
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: