Individual
MISS RYAN STEPHANIE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-1500
Mailing address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 670-5653
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
41646
WY
363LP0200X
Pediatric Nurse Practitioner
Primary
53158
WY
Other
Enumeration date
04/10/2022
Last updated
07/31/2025
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