Provider Demographics
NPI:1255765897
Name:GOFF, DENNIS WAYNE (APRN)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:WAYNE
Last Name:GOFF
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 REFORMATORY ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-3081
Mailing Address - Country:US
Mailing Address - Phone:620-664-2844
Mailing Address - Fax:620-669-1219
Practice Address - Street 1:500 REFORMATORY ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-3081
Practice Address - Country:US
Practice Address - Phone:620-664-2844
Practice Address - Fax:620-669-1219
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-31
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5344034032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily