Provider Demographics
NPI:1376917500
Name:GOODE, CELIA PATRICIA (FNP)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:PATRICIA
Last Name:GOODE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 HOSPITAL DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5775
Mailing Address - Country:US
Mailing Address - Phone:361-579-1381
Mailing Address - Fax:361-574-1558
Practice Address - Street 1:2705 HOSPITAL DR
Practice Address - Street 2:SUITE 400
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5775
Practice Address - Country:US
Practice Address - Phone:361-579-1381
Practice Address - Fax:361-574-1558
Is Sole Proprietor?:No
Enumeration Date:2015-11-27
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily