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Contact Information

BEATRICE L GODBOULDT, PA-C
821 N NELLIS BLVD
LAS VEGAS, NV89110-5339
 Phone: 702-438-4003
 Fax: 702-438-0555
 Website:
 

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
Indicates primary specialty

NPI Profile & details for BEATRICE L GODBOULDT · (Female)

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
  • CA License # PA12936
  • NV License # PA1710
  • NV Medicaid 1457406241
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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