Individual
JEFFREY GOODFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(775) 688-2001
(775) 688-2004
Mailing address
480 GALLETTI WAY, SPARKS, NV 89431-5564
(775) 688-2001
(775) 688-2004
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN33445
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN33445
RN LICENSE NUMBER
NV
Enumeration date
04/28/2015
Last updated
04/28/2015
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