Individual
MRS. REBECCA LEIGH GOEDECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
51 N DUNLAP ST, G145, MEMPHIS, TN 38105-4625
(901) 287-5928
(901) 266-6455
Mailing address
6656 BOOTH FORREST CV, BARTLETT, TN 38135-9118
(904) 705-1339
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
19922
TN
363LP0200X
Pediatric Nurse Practitioner
19922
TN
363LP0200X
Pediatric Nurse Practitioner
9382864
FL
Other
Enumeration date
09/26/2012
Last updated
04/04/2023
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