Provider Demographics
NPI:1649748765
Name:GOEDEN, ERICA (RN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GOEDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:DEGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6941 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-2818
Mailing Address - Country:US
Mailing Address - Phone:402-480-0261
Mailing Address - Fax:
Practice Address - Street 1:5905 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2235
Practice Address - Country:US
Practice Address - Phone:402-436-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60437163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE60437OtherREGISTERED NURSING LICENSE