Goodman, Gregory G

Goodman, Gregory G is an individual health care provider with primary practice located at 5325 Faraon St , Saint Joseph MO 64506-3488. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Goodman, Gregory G can be contacted via phone (816) 271-7986.

Contact Information

Primary practice address
5325 Faraon St Saint Joseph MO 64506-3488
Phone: (816) 271-7986
Fax: (816) 271-7986
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 095469 Missouri

Profile Details

NPI number 1215046768
LBN Legal business name Goodman, Gregory G
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Oct 13th, 2016 - about 8 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 1215046768 NPPES
Kansas MEDICAID 200553990C
Kansas MEDICAID 200553990B
Kansas MEDICAID 425076601
Kansas MEDICAID 540492501
Kansas MEDICAID 200553990A
Kansas Other 10001503301
Kansas Other 30405021
Kansas MEDICAID 200553990D

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