Goodrich, Renee Marie

Goodrich, Renee Marie is an sole proprietor health care provider with primary practice located at 1958 W Boulevard , Kokomo IN 46902-6078. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Ambulatory Health Care Facilities / Urgent Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Goodrich, Renee Marie can be contacted via phone (765) 865-0135.

Contact Information

Primary practice address
1958 W Boulevard Kokomo IN 46902-6078
Phone: (765) 865-0135
Fax: (765) 450-6744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28202615A Indiana
Ambulatory Health Care Facilities / Urgent Care 261QU0200X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71012832A Indiana

Profile Details

NPI number 1124750815
LBN Legal business name Goodrich, Renee Marie
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2022
Last updated May 27th, 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 1124750815 NPPES
Indiana Other 28202615A REGISTERED NURSE
Indiana Other 71012832A REGISTERED NURSE

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