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Individual

STACY GOODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2824 MAHAN DR STE 1, TALLAHASSEE, FL 32308-5429
(850) 558-1260
Mailing address
2824 MAHAN DR STE 1, TALLAHASSEE, FL 32308-5429
(850) 558-1260

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
9479555
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ARNP9479555
STATE LICENSE
FL
Enumeration date
02/29/2016
Last updated
03/04/2020
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