Individual
HEATHER GOETZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-0001
(585) 341-3015
Mailing address
601 ELMWOOD AVE BOX 635, ROCHESTER, NY 14642-0001
(585) 275-8138
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
381638
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107390400
—
FL
01
—
6JHN4
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/16/2006
Last updated
09/01/2023
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