Individual
MIKAELA R GOODWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
715 S 9TH ST, CANON CITY, CO 81212-4911
(719) 269-8820
Mailing address
715 S 9TH ST, CANON CITY, CO 81212-4911
(719) 269-8820
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.1000278-NP
CO
Other
Enumeration date
10/30/2024
Last updated
02/07/2025
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