Provider Demographics
NPI:1518938596
Name:GOODRICH, JOANNE B (APRN)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:B
Last Name:GOODRICH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PLEASANT ST
Mailing Address - Street 2:SUITE 6073
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7539
Mailing Address - Country:US
Mailing Address - Phone:603-227-7000
Mailing Address - Fax:603-227-7191
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:SUITE 6073
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7539
Practice Address - Country:US
Practice Address - Phone:603-227-7000
Practice Address - Fax:603-227-7191
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH034899-23-03363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHS32348Medicare UPIN
NH7850244OtherAETNA
NHS32348OtherHARVARD PILGRIM HLTHCARE
NH9848951OtherCIGNA
NHS32348Medicare UPIN
NHNP0223Medicare ID - Type Unspecified
NH383849OtherMVP