Provider Demographics
NPI:1255757217
Name:GOOD, PATRICIA L (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:GOOD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:BACKUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2035 JACOBS RUN RD
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:45157-9307
Mailing Address - Country:US
Mailing Address - Phone:937-725-5522
Mailing Address - Fax:
Practice Address - Street 1:2719 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3354
Practice Address - Country:US
Practice Address - Phone:949-484-9517
Practice Address - Fax:949-569-1295
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAG0314007363LA2200X
OHAPRN.CNP.15767363LA2200X
OHAPRN.CNP.15756363LP2300X
KY3008647363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health