Individual
KELSEY L GOODIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1373 E STATE ROAD 62 STE 2E, MADISON, IN 47250-7328
(812) 801-0820
(812) 801-0027
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28244373A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012671A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300064344
—
IN
05
—
7100831330
—
KY
Enumeration date
06/21/2022
Last updated
10/09/2025
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