Individual
HOLLY ANINE GOODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
416 W 48TH ST STE 28, KEARNEY, NE 68845-1314
(308) 708-7631
Mailing address
3919 17TH AVE, KEARNEY, NE 68845-2307
(970) 580-0723
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
113169
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113169
APRN-NURSE PRACTITIONER
NE
Enumeration date
09/14/2020
Last updated
09/30/2020
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