Individual
MRS. BRENDA LEE GOODNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
802 KENYON RD, FORT DODGE, IA 50501-5740
(515) 573-3101
Mailing address
8921 TWIN LAKES RD, MANSON, IA 50563-7012
(515) 570-0859
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
125895
IA
363L00000X
Nurse Practitioner
Primary
A179734
IA
Other
Enumeration date
03/08/2024
Last updated
03/07/2025
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