Individual
SEAN GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
9025 COLDWATER RD STE 100, FORT WAYNE, IN 46825-2071
(260) 459-9225
(260) 800-1512
Mailing address
9025 COLDWATER RD STE 100, FORT WAYNE, IN 46825-2071
(260) 459-9225
(260) 800-1512
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1133599
KY
363L00000X
Nurse Practitioner
Primary
28206231
IN
Other
Enumeration date
09/07/2018
Last updated
02/21/2024
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