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Contact Information

HANNAH L GOODRUM, PA-C
210 ASHVILLE AVE
CARY, NC27518-6676
 Phone: 919-350-9355
 Fax: 919-851-6757
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for HANNAH L GOODRUM · (Female)

NPI Number 1073246203
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/06/2022
Last updated 03/31/2026 - About 2 months ago
Sole proprietor 1 No
Identifiers
  • NC License # 0010-12258
  • NC Medicaid 1073246203
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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