Individual
MOLLY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12409 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2507
(314) 455-4046
Mailing address
689 W LOCKWOOD AVE, SAINT LOUIS, MO 63119-3540
(314) 719-7379
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020008728
MO
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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