Laure Cecile Goudiaby, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R194709 Issued in MD

Practice address

3200 Crain Hwy
Waldorf, MD 20603-4841

Phone

(301) 396-9215

NPI assigned

Apr 6, 2018

Last updated

Apr 6, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1710484886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22347 CANTERFIELD WAY",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764375",
            "telephone_number": "301-972-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CRAIN HWY",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034841",
            "telephone_number": "301-396-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDIABY",
        "first_name": "LAURE",
        "middle_name": "CECILE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R194709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.