Individual
DOROTHY DENISE GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP MSN RN
Contact information
Practice address
850 CENTRAL PKWY E STE 275, PLANO, TX 75074
(972) 881-4688
Mailing address
850 CENTRAL PKWY E STE 275, PLANO, TX 75074-5542
(728) 814-6889
(972) 372-1657
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP115315
TX
363LF0000X
Family Nurse Practitioner
500013
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184990303
—
TX
01
—
500013
NURSING LICENSE
TX
01
—
8Y3816
BLUE CROSS
TX
Enumeration date
10/12/2006
Last updated
06/13/2024
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