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General NPI Number Information
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NPI Number | 1508859984
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Entity Type | Individual
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Provider Name | COLLEEN KING GOODE DNP, MA, FNP-BC, CNE
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Gender | Female
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 1404 S MAIN CHAPEL WAY STE 104
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City | GAMBRILLS
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State | MD
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Zip | 21054-1860
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Country | US
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Telephone | 443-814-9108
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Fax |
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Provider Business Mailing Address
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Address Line | 2947 ROBIN RD
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City | YORK
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State | PA
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Zip | 17404-5769
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R201512
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R201512
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License Number State | MD
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