Individual
MRS. ELIZABETH A. BLACKGOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6184
Mailing address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6184
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
RN078643
AZ
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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