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Organization
PROMENADE PRIMARY CARE LLC
Active
Organization
PROMENADE PRIMARY CARE LLC
Active
Other names
Kelly Goodman NP and Associates PC
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GOODMAN NP (OWNER)
(202) 684-7167
Entity
Organization
Contact information
Practice address
4701 SANGAMORE RD, SUITE S207, BETHESDA, MD 20816-2508
(202) 684-7167
Mailing address
955 LENFANT PLZ SW, SUITE 325, WASHINGTON, DC 20024-2119
(202) 684-7167
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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