MEDICARE: GERALDA B GOODIN 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	363LF0000X	Family Nurse Practitioner	322813	AZ

General Provider Information

NPI Number	:	1447048335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALDA B GOODIN FNP-C

Provider Business Mailing Address
First Line	:	2171 W ORANGE GROVE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3118
Country	:	US
Telephone Number	:	520-297-3907
Fax Number	:	520-989-3586

Provider Business Practice Location Address
First Line	:	2171 W ORANGE GROVE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3118
Country	:	US
Telephone Number	:	520-297-3907
Fax Number	:	520-989-3586

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

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	02/17/2026

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