Doctor Name: | KATHRYN MICHELLE GODLY |
NPI Number: | 1336474907 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | 0010-03453 |
Business Practice Address: | 716 S 10th St. Lillington, NC - 27546 |
Business Phone Number: | 9108141212 |
Business Fax Number: | |
Mailing Address: | 224 Dutch Hill Rd, HOLLY SPRINGS |
State: | NC |
Postal Code: | 275408525 |
Phone Number: | 8458931212 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2009 |
NPI Last Update Date: | 07/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0010-03453 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |