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NPI Profile for RYAN S GOODMAN in GILLETTE, WY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
363LP0200X | 50 | Nurse Practitioner | |
Registered Nurse |
163W00000X |
| NPI Number | 1710629704 |
|
| Status | Active | |
| Credentials | CPNP-AC | |
| Entity | Individual | |
| Enumeration date | 04/10/2022 | |
| Last updated | 07/31/2025 - About 10 months ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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RYAN S GOODMAN
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RYAN S GOODMAN, CPNP-AC