Individual
SHERYL P GOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
830 OAK ST, SUITE 105W, BROCKTON, MA 02301-1168
(508) 427-3668
(508) 427-2610
Mailing address
830 OAK ST, SUITE 105W, BROCKTON, MA 02301-1168
(508) 427-3668
(508) 427-2610
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
170600
MA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
170600
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0355241
—
MA
01
—
28308
HEALTHNET
MA
01
—
616882
TUFTS
MA
01
—
PN0849
BLUE CROSS
MA
Enumeration date
11/07/2005
Last updated
05/07/2008
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