Individual
AMANDA LEE GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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