Individual
COLLEEN NICOLE GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1605 W MAIN ST, RUSSELLVILLE, AR 72801-2719
(479) 219-5008
Mailing address
1605 W MAIN ST, RUSSELLVILLE, AR 72801-2719
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
225193
AR
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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