Goddard, Amanda Lee

Goddard, Amanda Lee is an individual health care provider with primary practice located at 5625 S 62Nd St Ste 100 , Lincoln NE 68516-3558. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Goddard, Amanda Lee can be contacted via phone (402) 489-3834.

Contact Information

Primary practice address
5625 S 62Nd St Ste 100 Lincoln NE 68516-3558
Fax: (402) 489-5049
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 110662 Nebraska

Profile Details

NPI number 1467558833
LBN Legal business name Goddard, Amanda Lee
Credentials RN, APRN
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Mar 20th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467558833 NPPES
Nebraska MEDICAID 10026369300
Nebraska MEDICAID 47079049100
Nebraska MEDICAID 10025151600
Nebraska MEDICAID 47079049112

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