Individual
RACHEL LAUREN GOODWYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
13460 N 94TH DR STE J1, PEORIA, AZ 85381-4246
(623) 876-8816
(623) 298-0168
Mailing address
13460 N 94TH DR STE J1, PEORIA, AZ 85381-4246
(623) 876-8816
(623) 298-0168
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
57242
NM
363LG0600X
Gerontology Nurse Practitioner
Primary
246985
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246985
AZ-NP LICENSE
AZ
Enumeration date
08/22/2019
Last updated
08/24/2021
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