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General NPI Number Information
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NPI Number | 1689610925
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Entity Type | Individual
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Provider Name | GEOFFREY LLOYD GODFREY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 09/28/2015
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Provider Practice Location Address
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Address Line | 19636 N 27TH AVE STE 190
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City | PHOENIX
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State | AZ
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Zip | 85027-4013
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Country | US
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Telephone | 623-516-8252
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Fax | 623-516-8253
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Provider Business Mailing Address
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Address Line | 1211 24TH ST
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City | ANACORTES
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State | WA
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Zip | 98221-2562
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Country | US
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Telephone | 360-299-4216
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Fax | 360-299-1369
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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 | AP60341324
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License Number State | WA
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