Individual
STACEY LYNN GODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
12 GILL ST, WOBURN, MA 01801-1765
(781) 939-7397
Mailing address
1302 BRADFORD CT, PHOENIXVILLE, PA 19460-4810
(610) 935-4608
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN546954
PA
363L00000X
Nurse Practitioner
Primary
SP010635
PA
Other
Enumeration date
12/04/2009
Last updated
12/09/2009
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