Individual
MR. CHARLIE E. GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.R.N.
Contact information
Practice address
206 S PATTERSON ST, VALDOSTA, GA 31601-5668
(229) 333-5257
(229) 333-7822
Mailing address
3707 FERN BANK RD, VALDOSTA, GA 31601-2754
(229) 559-4189
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN044631
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000440184A
—
GA
05
—
000440184C
—
GA
05
—
00044018B
—
GA
Enumeration date
12/28/2006
Last updated
03/02/2017
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