Individual
MRS. MARY ALICE GOODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, CRNA
Contact information
Practice address
7348 PRINCESS ANNE DR, MECHANICSVILLE, VA 23111-1338
(919) 604-3971
Mailing address
7348 PRINCESS ANNE DR, MECHANICSVILLE, VA 23111-1338
(919) 604-3971
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001180074
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024165253
VA
367500000X
Certified Registered Nurse Anesthetist
120351
NC
367500000X
Certified Registered Nurse Anesthetist
RNA183048
ME
Other
Enumeration date
03/01/2007
Last updated
12/18/2018
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