Goodspeed, Rebecca J

Goodspeed, Rebecca J is an individual health care provider with primary practice located at 3025 W Cherry Ln Suite B, Meridian ID 83642-8531. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Goodspeed, Rebecca J can be contacted via phone (208) 302-6450.

Contact Information

Primary practice address
3025 W Cherry Ln Suite B Meridian ID 83642-8531
Phone: (208) 302-6450
Fax: (208) 302-6455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA524 Idaho

Profile Details

NPI number 1750327797
LBN Legal business name Goodspeed, Rebecca J
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Nov 15th, 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 1750327797 NPPES
Idaho MEDICAID 807176000

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