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General NPI Number Information
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NPI Number | 1366598013
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Entity Type | Individual
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Provider Name | NICOLE B GOLDING M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 455 SAINT MICHAELS DR
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City | SANTA FE
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State | NM
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Zip | 87505-7601
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Country | US
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Telephone | 505-913-5470
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Fax | 505-913-6489
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Provider Business Mailing Address
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Address Line | 455 SAINT MICHAELS DR
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City | SANTA FE
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State | NM
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Zip | 87505-7601
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Country | US
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Telephone | 505-913-5470
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Fax | 505-913-6489
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0430700
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD2011-0221
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License Number State | NM
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