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General NPI Number Information
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NPI Number | 1518677012
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Entity Type | Individual
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Provider Name | CAROLINE DOROTHY GOODE LNP
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Gender | Female
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Dates
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Enumeration Date | 11/25/2022
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Last Update Date | 11/25/2022
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Provider Practice Location Address
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Address Line | PAVILION A, 659 HOSPITAL RD,
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560
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Country | US
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Telephone | 804-443-6020
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Fax |
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Provider Business Mailing Address
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Address Line | 8771 MATOAKA GLEN RD
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City | QUINTON
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State | VA
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Zip | 23141-1393
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Country | US
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Telephone | 804-921-2578
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024185826
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License Number State | VA
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