Individual
MS. NIKKI BELLE GOFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
LYSTER ARMY HEALTH CLINIC, BUILDING 301, ANDREWS AVE, FT. RUCKER, AL 36362-5333
(334) 255-7894
(334) 255-7368
Mailing address
LYSTER ARMY HEALTH CLINIC, BUILDING 301, ANDREWS AVE, FT. RUCKER, AL 36362-5333
(334) 255-7171
(334) 255-7368
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-097660
AL
163WP2201X
Ambulatory Care Registered Nurse
1-097660
AL
Other
Enumeration date
10/21/2008
Last updated
04/08/2015
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