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Contact Information

CARRIE C GOODRUM, FNP
1520 S. DOBSON RD.
SUITE 203
MESA, AZ85202
 Phone: 480-461-8400
 Fax: 480-461-8408
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CARRIE C GOODRUM · (Female)

NPI # 1063634475
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 05/03/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # AP2157
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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