Individual
JANE W GODDARD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
23 MANSFIELD AVE, BURLINGTON, VT 05401-3323
(802) 863-6326
Mailing address
67 UNION ST, WINOOSKI, VT 05404-1948
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
1010010177
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4000026
—
VT
Enumeration date
05/26/2006
Last updated
07/09/2007
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