Individual
MRS. NANCY JEAN BODMAN-GOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
150 MUNDY STREET, WILKES-BARRE, PA 18702
(570) 824-0930
(570) 824-7755
Mailing address
150 MUNDY ST, WILKES BARRE, PA 18702-6830
(570) 824-0930
(570) 824-7755
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SP009237
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103103381-0001
—
PA
Enumeration date
07/31/2006
Last updated
07/25/2016
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