Goodman, Amy D

Goodman, Amy D is an sole proprietor health care provider with primary practice located at 1375 Oakwood Ct , San Luis Obispo CA 93401-5918. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is her primary health care specialty. Goodman, Amy D can be contacted via phone (970) 379-5531.

Contact Information

Primary practice address
1375 Oakwood Ct San Luis Obispo CA 93401-5918
Phone: (970) 379-5531
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRNA000233 Nevada
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRNA-183907 Colorado
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 2974 California

Profile Details

NPI number 1942292701
LBN Legal business name Goodman, Amy D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2005
Last updated Jun 1st, 2016 - about 9 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 1942292701 NPPES
Nevada MEDICAID 100503782

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