Tamara Lee Goodrich, REGISTERED NURSE
Individual provider Active NPI Registered Nurse · Tremonton, UT
NPI 1225848708 · NPPES record last updated Jan 8, 2025
Key facts
- NPI
- 1225848708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 362490-3102 (UT)
- Practice address
- 2711 W 450 N Apt 4F
Tremonton, UT 84337-2612 - Phone
- (435) 282-6195
- NPI assigned
- Jan 8, 2025
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 362490-3102 | UT | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 362490-3102 | UT | Yes |
Addresses
Primary practice location
2711 W 450 N Apt 4F
Tremonton, UT 84337-2612
Mailing address
2711 W 450 N Apt 4F
Tremonton, UT 84337-2612
Phone (435) 282-6195
Other providers in Tremonton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.