Individual
ELIZABETH SHELLY GOODIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.F.A,M.S.N.,CNM
Contact information
Practice address
3650 JOSEPH SIEWICK DR, SUITE 203, FAIRFAX, VA 22033-1710
(703) 391-1500
(703) 860-1549
Mailing address
2028 OPITZ BLVD, SUITE ONE, WOODBRIDGE, VA 22191-3306
(703) 690-2295
(703) 690-6445
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001074325
VA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
0024074325
VA
367A00000X
Advanced Practice Midwife
Primary
0001074325
VA
Other
Enumeration date
01/09/2007
Last updated
10/13/2007
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