MEDICARE: ERIKA GOFF APRN, FNP-BC

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	163WE0003X	Emergency Registered Nurse	912895	TX
2	363LP2300X	Primary Care Nurse Practitioner	1000145	TX

General Provider Information

NPI Number	:	1457971764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA GOFF APRN, FNP-BC

Provider Business Mailing Address
First Line	:	2801 MILLENNIUM DR STE B
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-3571
Country	:	US
Telephone Number	:	860-538-1871
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 BRIDGEVIEW DR APT 1235
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-5572
Country	:	US
Telephone Number	:	860-538-1871
Fax Number	:

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

Provider Enumeration Date	:	04/16/2020
Last Update Date	:	06/23/2020

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