Individual
AMANDA LEE GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN
Contact information
Practice address
5625 S 62ND ST STE 100, LINCOLN, NE 68516-3558
(402) 489-3834
(402) 489-5049
Mailing address
5625 S 62ND ST STE 100, LINCOLN, NE 68516-3558
(402) 489-3834
(024) 895-0494
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
110662
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025151600
—
NE
05
—
10026369300
—
NE
05
—
47079049100
—
NE
05
—
47079049112
—
NE
Enumeration date
09/15/2006
Last updated
03/20/2024
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