Individual
CAROL GOODREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1563 N 2ND DR, STEVENS POINT, WI 54482-9623
(715) 892-4299
Mailing address
1563 N 2ND DR, STEVENS POINT, WI 54482-9623
(715) 892-4299
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
170046
WI
163WP0808X
Psychiatric/Mental Health Registered Nurse
4704222349
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170046
WI RN LICENSE
WI
01
—
4704222349
MI REGISTERED NURSE LICENSE NUMBER
MI
Enumeration date
07/25/2013
Last updated
04/08/2015
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