| Doctor Name: | MS. NIKKI BELLE GOFORTH |
| NPI Number: | 1124270327 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 1-097660 |
| Business Practice Address: | Lyster Army Health Clinic Building 301, Andrews Ave Ft. Rucker, AL - 363625333 |
| Business Phone Number: | 3342557894 |
| Business Fax Number: | 3342557368 |
| Mailing Address: | Lyster Army Health Clinic, Building 301, Andrews Ave FT. RUCKER |
| State: | AL |
| Postal Code: | 363625333 |
| Phone Number: | 3342557171 |
| Fax Number: | 3342557368 |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 04/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | 1-097660 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |