Doctor Name: | PAMELA GOINES |
NPI Number: | 1194132365 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | COA 16194-NP |
Business Practice Address: | 1509 S Conwell Ave Willard, OH - 448909448 |
Business Phone Number: | 4199645140 |
Business Fax Number: | 4199645722 |
Mailing Address: | 1509 S Conwell Ave, WILLARD |
State: | OH |
Postal Code: | 448909448 |
Phone Number: | 4199645140 |
Fax Number: | 4199645722 |
NPI Enumeration Date: | 07/18/2014 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA 16194-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |