Goddard, Deborah Jean

Goddard, Deborah Jean is an individual health care provider with primary practice located at 300 Health Park Blvd , St Augustine FL 32086-3707. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Goddard, Deborah Jean can be contacted via phone (904) 819-4747.

Contact Information

Primary practice address
300 Health Park Blvd St Augustine FL 32086-3707
Phone: (904) 819-4747
Fax: (904) 819-5080
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP 3353562 Florida

Profile Details

NPI number 1770521874
LBN Legal business name Goddard, Deborah Jean
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Jan 15th, 2014 - about 12 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 1770521874 NPPES
Florida MEDICAID 306983400

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