Brenda B Goolsby, RN

Individual provider Active NPI Community Health Registered Nurse · Lincolnton, GA

NPI 1104908144 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104908144
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
RN054204 (GA)
Practice address
176 N. Peachtree Street
Lincolnton, GA 30817
Phone
(706) 359-3154
Fax
(706) 359-1939
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN054204GAMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN054204 GA Yes

Addresses

Primary practice location

176 N. Peachtree Street
Lincolnton, GA 30817

Mailing address

72 Kelly St
Lincolnton, GA 30817-2800
Phone (706) 359-1196

Other providers in Lincolnton, GA

All providers in Lincolnton, GA · Community Health Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.