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NPI Code Detail

MEDICARE: BRITTANY GOODLING LPN

MEDICARE:   BRITTANY  GOODLING  LPN
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
1164W00000XLicensed Practical Nurse4703123392MI

General Provider Information

NPI Number : 1295313393
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY GOODLING LPN
Provider Business Mailing Address
First Line : 5684 SHORE DR
Second Line :
City : ORCHARD LAKE
State : MI
Zip : 48324-2954
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5684 SHORE DR
Second Line :
City : ORCHARD LAKE
State : MI
Zip : 48324-2954
Country : US
Telephone Number : 248-982-7951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2021
Last Update Date : 03/30/2021

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Directions to “ BRITTANY GOODLING LPN” Practice Location

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