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Individual
KELLEY ERIN GODBOUT
Active
Individual
KELLEY ERIN GODBOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-10761
NC
Other
Enumeration date
01/26/2020
Last updated
07/21/2022
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