Godbouldt, Beatrice Lee

Godbouldt, Beatrice Lee is an individual health care provider with primary practice located at 821 N Nellis Blvd , Las Vegas NV 89110-5339. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Godbouldt, Beatrice Lee can be contacted via phone (702) 438-4003.

Contact Information

Primary practice address
821 N Nellis Blvd Las Vegas NV 89110-5339
Phone: (702) 438-4003
Fax: (702) 438-0555
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X PA12936 California
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA12936 California
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA1710 Nevada

Profile Details

NPI number 1457406241
LBN Legal business name Godbouldt, Beatrice Lee
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2007
Last updated Mar 17th, 2017 - about 9 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 1457406241 NPPES
Nevada MEDICAID 1457406241

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