Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 084509-23 | NH |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | NA | MA |
NPI | 1215574876 |
---|---|
Provider Name | Rachael Goodick |
First Address | Boston, MA 02118-3155 |
Second Address | Manchester, NH 03103-3599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2019 |
Last Update Date | 04/03/2021 |