Kristy Love Goodwin-Fuller
Individual provider Active NPI Non-emergency Medical Transport (VAN) · Gloster, LA
NPI 1801319876 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1801319876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Non-emergency Medical Transport (VAN) 343900000X
- Practice address
- 118 Sinclair LN
Gloster, LA 71030-3028 - Phone
- (318) 933-8422
- Fax
- (318) 933-8415
- NPI assigned
- Jul 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | Yes |
Addresses
Primary practice location
118 Sinclair LN
Gloster, LA 71030-3028
Mailing address
118 Sinclair LN
Gloster, LA 71030-3028
Phone (318) 933-8422
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82-1289809 | Other | LA | INTERNAL REVENUE |
Other providers in Gloster, LA
- Ami Michelle Altom
- Marshale Chism
- Virginia Fuller
- Dobrielle Gatlin
- Angie Hines
- Elizabeth Phillips
- Remarkable Transport LLC
- Danyelle Scroggins
All providers in Gloster, LA · Non-emergency Medical Transport (VAN) in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.