Provider Demographics
NPI:1093494601
Name:GOOLD, AIMEE M (ARNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:M
Last Name:GOOLD
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2021
Mailing Address - Street 2:
Mailing Address - City:VERADALE
Mailing Address - State:WA
Mailing Address - Zip Code:99037-2021
Mailing Address - Country:US
Mailing Address - Phone:509-939-8253
Mailing Address - Fax:
Practice Address - Street 1:16201 E INDIANA AVE STE 3260
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2846
Practice Address - Country:US
Practice Address - Phone:509-863-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61425714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily