Provider Demographics
NPI:1538312780
Name:GOEHRING, LAWANDA NADINE (NP)
Entity Type:Individual
Prefix:
First Name:LAWANDA
Middle Name:NADINE
Last Name:GOEHRING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAWANDA
Other - Middle Name:NADINE
Other - Last Name:CURRY-MACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5400 E FOWLER AVE
Mailing Address - Street 2:STE C253
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2222
Mailing Address - Country:US
Mailing Address - Phone:917-502-8345
Mailing Address - Fax:
Practice Address - Street 1:820 DRUID HILLS RD
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3812
Practice Address - Country:US
Practice Address - Phone:917-565-3687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-01
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010006363L00000X, 363LA2200X
FLAPRN9428628363LA2200X, 363L00000X
NY302244363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health