Healthcare Provider Details

I. General information

NPI: 1891559407
Provider Name (Legal Business Name): DR. BETH A. GOOD DNP, APRN, PMHCNS-BC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 2ND AVE SE
CAMBRIDGE MN
55008-1602
US

IV. Provider business mailing address

145 2ND AVE SE
CAMBRIDGE MN
55008-1602
US

V. Phone/Fax

Practice location:
  • Phone: 866-435-1128
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BETH ANN GOOD
Title or Position: OWNER
Credential:
Phone: 320-496-4663