Gooding, Legenda

Gooding, Legenda is an individual health care provider with primary practice located at 1475 W Grand Ave , Port Washington WI 53074-2074. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Gooding, Legenda can be contacted via phone (262) 268-5100.

Contact Information

Primary practice address
1475 W Grand Ave Port Washington WI 53074-2074
Phone: (262) 268-5100
Fax: (262) 268-5115
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 7303-33 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 7303 Wisconsin

Profile Details

NPI number 1093255549
LBN Legal business name Gooding, Legenda
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2017
Last updated Jul 15th, 2024 - about 2 years ago

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 1093255549 NPPES
Wisconsin MEDICAID 100065765

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