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General NPI Number Information
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NPI Number | 1548186687
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Entity Type | Individual
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Provider Name | DIANNE NICHOLE GOODBAR NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 25201 CHAGRIN BLVD STE 180
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City | BEACHWOOD
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State | OH
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Zip | 44122-5633
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Country | US
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Telephone | 216-464-1616
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Fax | 216-464-1618
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Provider Business Mailing Address
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Address Line | 60 GREENTREE RD
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City | CHAGRIN FALLS
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State | OH
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Zip | 44022-2423
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Country | US
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Telephone | 571-527-6467
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN.CNP.0042528
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License Number State | OH
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