Healthcare Provider Details

I. General information

NPI: 1164882072
Provider Name (Legal Business Name): KAREN GOFF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 PINEVIEW FLATS RD
HAMBLETON WV
26269-8037
US

IV. Provider business mailing address

42 PINEVIEW FLATS RD
HAMBLETON WV
26269-8037
US

V. Phone/Fax

Practice location:
  • Phone: 304-478-2196
  • Fax:
Mailing address:
  • Phone: 304-478-2196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number43931
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: