Individual
DANA GOFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1025 MOREHEAD MEDICAL DR, SUITE 600, CHARLOTTE, NC 28204-2963
(704) 355-8816
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010743
NC
363L00000X
Nurse Practitioner
NUR-APRN-LIC-153605
MT
Other
Enumeration date
07/26/2018
Last updated
04/18/2025
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