Anna Hazel Goddard, APRN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

3291 Issued in CT

Practice address

7 Vauxhall St
Child & Family Agency of Sect, Inc.
New London, CT 06320-5711

Phone

(860) 442-2797

Fax

(860) 701-3776

NPI assigned

Aug 21, 2006

Last updated

Apr 5, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Anna Hazel Tielsch-Goddard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1720194939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206204",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 VAUXHALL ST",
            "address_2": "CHILD & FAMILY AGENCY OF SECT, INC.",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205711",
            "telephone_number": "860-442-2797",
            "fax_number": "860-701-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "ANNA",
        "middle_name": "HAZEL",
        "name_prefix": "Mrs.",
        "credential": "APRN, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "765853",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "3291",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "73362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "TIELSCH-GODDARD",
            "middle_name": "HAZEL",
            "credential": "APRN, CPNP-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen Gingerella, PA-C
• Robert Ginther, PA
• Bernard A. Giserman, M.D.
• Nancy Robin Gluckcoleman, COTA
• Naomi Gobeille, CISW
• Adriana Shea Godfrey, FNP-C
• Gold Coast Pulmonary and Sleep Assoc (Nurse Practitioner)
• Gold Coast Pulmonary and Sleep Associates, LLC
• Jeffrey Stuart Gold, M.D.
• Bernadette Golden, LMFT

• Pediatric Nurse Practitioner in New London, CT
• Providers in New London, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.