Individual
MRS. MICA RAE GOEHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
31038 COUNTRY GDNS STE D2, DAGSBORO, DE 19939-5410
(025) 890-0193
(800) 349-1807
Mailing address
31038 COUNTRY GDNS STE D2, DAGSBORO, DE 19939-5410
(302) 589-0019
(800) 349-1807
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
LG-0011594
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LG-001594
DE FNP LICENSE
DE
Enumeration date
03/14/2021
Last updated
04/28/2025
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