Individual
KAITLINN MARY GOODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
622 WEST 168 STREET PH8 EAST ROOM 101 NY, NY 10032, NEW YORK, NY 10032
(212) 305-9817
Mailing address
1605 SANSOM ST APT 700, PHILADELPHIA, PA 19103-5146
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
431440
NY
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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