Individual
GOLDYN PROMISE CANO
Active
Individual
GOLDYN PROMISE CANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5036
TN
363A00000X
Physician Assistant
PA2012-0033
NM
363AS0400X
Surgical Physician Assistant
Primary
5036
TN
363AS0400X
Surgical Physician Assistant
PA2012-0033
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01931288
—
NM
01
—
P01322421
MEDICARE - RAILROAD
NM
Enumeration date
09/21/2012
Last updated
09/24/2025
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