Provider Demographics
NPI:1821286634
Name:GOULKER, CINDY LYNNE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LYNNE
Last Name:GOULKER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 W STATE ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1515
Mailing Address - Country:US
Mailing Address - Phone:614-228-2727
Mailing Address - Fax:614-228-8118
Practice Address - Street 1:5969 E BROAD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1546
Practice Address - Country:US
Practice Address - Phone:614-863-1692
Practice Address - Fax:614-575-5382
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN267066163W00000X
OHNP-07941363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse