Individual
KELLEY ERIN GODBOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-4963
(336) 716-2011
Mailing address
5019 OLDE STONE LN, MATTHEWS, NC 28104-3354
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-10761
NC
Other
Enumeration date
01/26/2020
Last updated
07/21/2022
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