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Individual

CARRIE D GOFORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
201 ABRAHAM FLEXNER WAY, SUITE 100, LOUISVILLE, KY 40202-3841
(502) 587-8222
(502) 587-0860
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(502) 587-8222
(502) 587-0860

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1105780
KY
363L00000X
Nurse Practitioner
Primary
3006398
KY

Other

Enumeration date
06/10/2010
Last updated
01/11/2011
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