Goodrich, Kelly L

Goodrich, Kelly L is an sole proprietor health care provider with primary practice located at 660 S Main St , Oregon WI 53575-3647. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Home Health. Nursing Service Providers / Registered Nurse is his primary health care specialty. Goodrich, Kelly L can be contacted via phone (608) 333-9160.

Contact Information

Primary practice address
660 S Main St Oregon WI 53575-3647
Phone: (608) 333-9160
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X Wisconsin
Nursing Service Providers / Home Health 163WH0200X Wisconsin

Profile Details

NPI number 1508988171
LBN Legal business name Goodrich, Kelly L
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2007
Last updated Jul 9th, 2007 - about 17 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 1508988171 NPPES
Wisconsin MEDICAID 38337300

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