Individual
RYAN PATRICK GOODNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
(479) 968-1198
Mailing address
500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
(479) 968-1198
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R098422
AR
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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