MEDICARE: ANNA KATHLEEN GOEHNER

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1780549451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA KATHLEEN GOEHNER

Provider Business Mailing Address
First Line	:	3276 PIN OAK DR
Second Line	:
City	:	ROCKINGHAM
State	:	VA
Zip	:	22801-5325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 MARTHA JEFFERSON DR
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-4668
Country	:	US
Telephone Number	:	434-654-7000
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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