Provider Demographics
NPI:1629745674
Name:GOODIER, CORRIE H (FNP)
Entity Type:Individual
Prefix:
First Name:CORRIE
Middle Name:H
Last Name:GOODIER
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 1:4393 GREEN MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CO
Mailing Address - Zip Code:80536-8762
Mailing Address - Country:US
Mailing Address - Phone:970-744-9725
Mailing Address - Fax:
Practice Address - Street 1:1000 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:CO
Practice Address - Zip Code:80759-2641
Practice Address - Country:US
Practice Address - Phone:970-848-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996829-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily