Individual
ELSA LYNN GODDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1617 N MAIN ST STE 101, FUQUAY VARINA, NC 27526-9021
(984) 215-6595
(984) 215-6596
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 269-6583
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13234
NC
363AM0700X
Medical Physician Assistant
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220144340
—
MO
Enumeration date
03/15/2017
Last updated
07/24/2025
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