NPI Profile for BEATRICE L GODBOULDT in LAS VEGAS, NV.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant | |
Emergency Medicine |
207P00000X | 93 | Physician/Emergency Medicine | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI # | 1457406241 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 01/24/2007 | |
| Last updated | 03/17/2017 - About 9 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BEATRICE L GODBOULDT
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