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General NPI Number Information
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NPI Number | 1356337208
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Entity Type | Individual
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Provider Name | DEBORAH CARROLL GOOTEE PSYCHIATRIC NURSE PR
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Gender | Female
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 29516 CANVASBACK DR
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City | EASTON
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State | MD
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Zip | 21601-7140
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Country | US
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Telephone | 410-822-5007
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Fax | 410-822-5569
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Provider Business Mailing Address
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Address Line | 2336 GODDARD PKWY
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City | SALISBURY
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State | MD
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Zip | 21801-1126
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Country | US
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Telephone | 410-334-6961
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Fax | 410-334-6362
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R053273
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R053273
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License Number State | MD
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