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Individual

MRS. AMANDA N GODDARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSN RN MSN FNP-BC

Contact information

Practice address
501 W 7TH ST, FREDERICK, MD 21701-4586
(240) 215-6310
(240) 566-7754
Mailing address
1 FREDERICK HEALTH WAY, FREDERICK, MD 21701-9435

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024178831
VA
363LF0000X
Family Nurse Practitioner
Primary
R205859
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1245878107
VA
01
VVY194A
MEDICARE PTAN
VA
Enumeration date
12/11/2019
Last updated
08/13/2026
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