Individual
HANNAH LEIGH GOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
0010-12258
NC
363A00000X
Physician Assistant
0010-12258
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-12258
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073246203
—
NC
Enumeration date
07/06/2022
Last updated
03/31/2026
Update your record
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