Individual
TERESA DIANE GOODNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10217 S WALNUT CANYON LN, SOUTH JORDAN, UT 84009-7141
(801) 651-8014
Mailing address
10217 S WALNUT CANYON LN, SOUTH JORDAN, UT 84009-7141
(801) 651-8014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
7041186-3102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7041186-4405
UT
Other
Enumeration date
05/07/2020
Last updated
09/23/2024
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