Provider Demographics
NPI:1770859753
Name:GOODE, PRECIOUS DENYSE ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:DENYSE ANNE
Last Name:GOODE
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 1:525 VERDAE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4021
Mailing Address - Country:US
Mailing Address - Phone:864-272-0388
Mailing Address - Fax:864-213-9237
Practice Address - Street 1:3020 REIDVILLE RD STE B
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-5641
Practice Address - Country:US
Practice Address - Phone:864-272-0388
Practice Address - Fax:864-213-9237
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily