| Doctor Name: | HEATHER A GOODALL |
| NPI Number: | 1053557645 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 3005661 |
| Business Practice Address: | 975 Hopkinsville Rd Russellville, KY - 422769774 |
| Business Phone Number: | 2707269568 |
| Business Fax Number: | 2707269570 |
| Mailing Address: | 975 Hopkinsville Rd, RUSSELLVILLE |
| State: | KY |
| Postal Code: | 422769774 |
| Phone Number: | 2707269568 |
| Fax Number: | 2707269570 |
| NPI Enumeration Date: | 01/02/2009 |
| NPI Last Update Date: | 10/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3005661 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |