MEDICARE: KAREN GOLDIE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	71008874A	IN
2	363L00000X	Nurse Practitioner	71009792A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114552882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN GOLDIE FNP-C

Provider Business Mailing Address
First Line	:	4933 PLAZA EAST BLVD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2813
Country	:	US
Telephone Number	:	812-479-6907
Fax Number	:	812-479-6967

Provider Business Practice Location Address
First Line	:	4933 PLAZA EAST BLVD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2813
Country	:	US
Telephone Number	:	812-479-6907
Fax Number	:	812-479-6967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	06/25/2024

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Directions to “ KAREN GOLDIE FNP-C” Practice Location

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