Healthcare Provider Details

I. General information

NPI: 1518821495
Provider Name (Legal Business Name): GOFFE HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 SULPHUR SPRING
HALETHORPE MD
21227
US

IV. Provider business mailing address

1334 SULPHUR SPRING (927 RADALLSTOWN, MD 21133)
HALETHORPE MD
21227
US

V. Phone/Fax

Practice location:
  • Phone: 410-935-7227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VANESHA GOFFE
Title or Position: OWNER
Credential: DNP
Phone: 763-670-5449