Doctor Name: | EVELYN W. GODWIN |
NPI Number: | 1417922980 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.P.R.N. |
License Number: | 001411 |
Business Practice Address: | 4 Hazel Ave Glendale Center Naugatuck, CT - 067704706 |
Business Phone Number: | 2037231456 |
Business Fax Number: | 2037230242 |
Mailing Address: | 166 Ridge Rd, MIDDLETOWN |
State: | CT |
Postal Code: | 064574433 |
Phone Number: | 8603477114 |
Fax Number: | |
NPI Enumeration Date: | 02/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 001411 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |