Provider Demographics
NPI:1609156165
Name:GOENAGA, MARIA ELENA (NP-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:GOENAGA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:GOENAGA
Other - Last Name:EPLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:315 BOULEVARD NE STE 224
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1220
Mailing Address - Country:US
Mailing Address - Phone:404-343-8249
Mailing Address - Fax:
Practice Address - Street 1:315 BOULEVARD NE STE 224
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1220
Practice Address - Country:US
Practice Address - Phone:404-343-8249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN164147363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health