Provider Demographics
NPI:1568071025
Name:GODFREY, CATHERINE CHIOMA
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:CHIOMA
Last Name:GODFREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 SNOWMASS CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-7439
Mailing Address - Country:US
Mailing Address - Phone:619-560-9888
Mailing Address - Fax:
Practice Address - Street 1:5304 SNOWMASS CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-7439
Practice Address - Country:US
Practice Address - Phone:619-560-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA348686163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse