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Individual

ORA GOODBAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
821 LOU AVE, CLIFTON FORGE, VA 24422-1634

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001-033080
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024-033080
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8934533
VA
05
8934541
VA
05
8934550
VA
05
8934568
VA
05
8934738
VA
Enumeration date
07/07/2006
Last updated
05/06/2008
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