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Individual
THERESA GOODENOUGH
Active
Individual
THERESA GOODENOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
2005453868
VA
363LF0000X
Family Nurse Practitioner
Primary
0024174270
VA
Other
Enumeration date
08/19/2015
Last updated
03/23/2020
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