Healthcare Provider Details

I. General information

NPI: 1831736560
Provider Name (Legal Business Name): CHERYL ELIZABETH GOOD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454-3002
US

IV. Provider business mailing address

1060 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454-3002
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-2323
  • Fax: 757-395-6280
Mailing address:
  • Phone: 757-395-2323
  • Fax: 757-395-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22735
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024182900
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: