Individual
MICHELE L. GOODBREAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4247 W RIDGE RD STE 101, ERIE, PA 16506-1746
(814) 835-2580
(814) 835-2590
Mailing address
4247 W RIDGE RD, ERIE, PA 16506-1746
(814) 835-2580
(814) 835-2590
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
1774
TN
363AM0700X
Medical Physician Assistant
MA053005
PA
363AM0700X
Medical Physician Assistant
OA006782
PA
363AM0700X
Medical Physician Assistant
Primary
PA.0008677
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516442
—
TN
Enumeration date
12/12/2007
Last updated
02/02/2026
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