Healthcare Provider Details

I. General information

NPI: 1841125291
Provider Name (Legal Business Name): SHICOLE GOFFINGTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 NC HIGHWAY 125
ROANOKE RAPIDS NC
27870-6351
US

IV. Provider business mailing address

8332 NC HIGHWAY 305
JACKSON NC
27845-9674
US

V. Phone/Fax

Practice location:
  • Phone: 252-537-1933
  • Fax:
Mailing address:
  • Phone: 252-673-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5024686
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: