Godboldt, Stacia Larose

Godboldt, Stacia Larose is an sole proprietor health care provider with primary practice located at 300 Health Park Blvd Ste 3002 , St Augustine FL 32086-3703. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Godboldt, Stacia Larose can be contacted via phone (904) 819-1500.

Contact Information

Primary practice address
300 Health Park Blvd Ste 3002 St Augustine FL 32086-3703
Phone: (904) 819-1500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X

Profile Details

NPI number 1356040018
LBN Legal business name Godboldt, Stacia Larose
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 1st, 2023
Last updated Mar 2nd, 2023 - about 3 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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