Healthcare Provider Details

I. General information

NPI: 1093296543
Provider Name (Legal Business Name): TRANISE HAMILTON GOODLOW AG-ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W ARBROOK BLVD STE 200
ARLINGTON TX
76014-3176
US

IV. Provider business mailing address

16980 DALLAS PKWY STE 200
DALLAS TX
75248-1974
US

V. Phone/Fax

Practice location:
  • Phone: 817-468-2028
  • Fax: 844-292-1463
Mailing address:
  • Phone: 972-391-1915
  • Fax: 972-391-2061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP137486
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704424388
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704424388
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: