Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 1068342 | FL |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | ARNP9247090 | FL |
NPI | 1194878660 |
---|---|
Provider Name | Ms. Kelly Elisabeth Goebel |
First Address | Naples, FL 34102-5754 |
Second Address | Naples, FL 34102-5754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2007 |
Last Update Date | 16/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014440500 | (05) | FL |
IC297Z | MEDICARE (01) | FL |