Individual
CHERYL ANN GOETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
520 WASHINGTON STREET, SUITE 104, GOVE, KS 67736-0128
(785) 938-2335
(785) 938-2336
Mailing address
PO BOX 128, SUITE 104, GOVE, KS 67736-0128
(785) 938-2335
(785) 938-2336
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
13-62595051
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
486010423
TRI-CARE
KS
Enumeration date
06/10/2011
Last updated
06/10/2011
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