Grippen Goddard, Amanda Violet
Grippen Goddard, Amanda Violet is an individual health care provider with primary practice located at 7001 Signal Ave Ne , Albuquerque NM 87113-2453. She recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as her primary health care specialty. Grippen Goddard, Amanda Violet can be contacted via phone (505) 826-2735.Contact Information
Primary practice address
7001 Signal Ave Ne
Albuquerque NM 87113-2453
Phone: (505) 826-2735
Fax: (505) 856-2749
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | A233920 | New Mexico |
Profile Details
| NPI number | 1710399654 |
|---|---|
| LBN Legal business name | Grippen Goddard, Amanda Violet |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2014 |
| Last updated | Oct 30th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710399654 | NPPES |
| New Mexico | Other | 1D3719 | MEDICARE PTAN |
| New Mexico | MEDICAID | 38337207 | MEDICARE PTAN |
| New Mexico | Other | 1D3721 | MEDICARE PTAN |
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