Individual
MICHAEL GOEDKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP OR PMHNP-BC
Contact information
Practice address
2781 PILOT KNOB RD, EAGAN, MN 55121-1119
(651) 289-7300
Mailing address
307 GRANDVIEW AVE W, ROSEVILLE, MN 55113-4701
(651) 353-0571
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6495
MN
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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