| Doctor Name: | KARENE MARIE GOODMAN |
| NPI Number: | 1114007333 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NURSE PRACTITIONER |
| License Number: | 094845 |
| Business Practice Address: | 715 St Rt Cc Rolla, MO - 65401 |
| Business Phone Number: | 5733085044 |
| Business Fax Number: | 5733415300 |
| Mailing Address: | Po Box 918, ROLLA |
| State: | MO |
| Postal Code: | 65401 |
| Phone Number: | 5733085044 |
| Fax Number: | 5733415300 |
| NPI Enumeration Date: | 10/16/2006 |
| NPI Last Update Date: | 02/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 094845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |