Provider Demographics
NPI:1639507957
Name:GOFF, ROBIN DENISE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:DENISE
Last Name:GOFF
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:DENISE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 US HIGHWAY 61
Mailing Address - Street 2:SUITE 310
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4100
Mailing Address - Country:US
Mailing Address - Phone:636-931-5080
Mailing Address - Fax:636-937-7321
Practice Address - Street 1:1400 US HIGHWAY 61
Practice Address - Street 2:SUITE 310
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4100
Practice Address - Country:US
Practice Address - Phone:636-931-5080
Practice Address - Fax:636-937-7321
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013038352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily