Individual
KARENE MARIE GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
715 ST RT CC, ROLLA, MO 65401
(573) 308-5044
(573) 341-5300
Mailing address
PO BOX 918, ROLLA, MO 65401
(573) 308-5044
(573) 341-5300
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
094845
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424960409
—
MO
01
—
500024104
RAILROAD MEDICARE
MO
Enumeration date
10/16/2006
Last updated
02/22/2008
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