Individual
MISS ANGELA MARIE GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1469 ASTOR AVE, BRONX, NY 10469-5846
(352) 281-4863
(347) 824-2978
Mailing address
12001 AVALON LAKE DR APT 326, ORLANDO, FL 32828-7379
(646) 457-8127
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
003941
CT
363LF0000X
Family Nurse Practitioner
F335139-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-1406459
TRICARE
CT
01
—
203941
CONNECTICARE
CT
01
—
3V2401
HEALTH NET
CT
01
—
400085656CT01
ANTHEM BCBS ON CT
CT
Enumeration date
06/14/2007
Last updated
05/02/2022
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