Healthcare Provider Details

I. General information

NPI: 1972700862
Provider Name (Legal Business Name): DONNA MARIE GOODIN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 COMMISSION CT STE 201
WOODBRIDGE VA
22192-1771
US

IV. Provider business mailing address

3401 COMMISSION CT STE 201
WOODBRIDGE VA
22192-1771
US

V. Phone/Fax

Practice location:
  • Phone: 703-490-6265
  • Fax: 703-490-6713
Mailing address:
  • Phone: 703-490-6265
  • Fax: 703-490-6713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024167386
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: