Individual
ALEXIS S GOODRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, MSN, PMHNP-BC
Contact information
Practice address
13260 SERVICE ROAD, WALTON, KY 41094
(859) 301-5901
(859) 301-5940
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-5901
(859) 301-5940
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3014449
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3014449
KY
Other
Enumeration date
03/31/2020
Last updated
11/29/2022
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