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General NPI Number Information
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NPI Number | 1902213770
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Entity Type | Individual
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Provider Name | TONYA GOODSON ARNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 4896 HIGHWAY 90 STE A
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City | MARIANNA
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State | FL
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Zip | 32446-7840
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Country | US
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Telephone | 850-526-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 4452 SINGER RD
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City | YOUNGSTOWN
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State | FL
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Zip | 32466-4520
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Country | US
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Telephone | 407-782-9907
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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 | ARNP9314865
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License Number State | FL
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