Provider Demographics
NPI:1326776162
Name:GOAD, ASHLEY (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:GOAD
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HARWINTON AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6507
Mailing Address - Country:US
Mailing Address - Phone:203-510-3090
Mailing Address - Fax:
Practice Address - Street 1:27 MAIN ST
Practice Address - Street 2:
Practice Address - City:TERRYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06786-5101
Practice Address - Country:US
Practice Address - Phone:860-314-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000000363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care