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General NPI Number Information
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NPI Number | 1396259479
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Entity Type | Individual
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Provider Name | CHARLOTTE RENAE GOODNIGHT RN
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Gender | Female
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 11/27/2017
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Provider Practice Location Address
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Address Line | 10103 RIDGEGATE PKWY STE G01
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City | LONE TREE
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State | CO
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Zip | 80124-5521
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Country | US
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Telephone | 720-225-1786
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Fax | 720-225-4208
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Provider Business Mailing Address
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Address Line | 2910 DRACO CIR
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City | MONUMENT
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State | CO
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Zip | 80132-9722
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Country | US
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Telephone | 719-213-8930
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Fax |
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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 | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | RN0201376
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License Number State | CO
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