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Individual
KAY ELLEN GOODALL
Active
Individual
KAY ELLEN GOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15461NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
05/19/2006
Last updated
01/25/2022
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