Provider Demographics
NPI:1265188528
Name:GOODEN, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GOODEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4282 TURKEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:VIOLA
Mailing Address - State:DE
Mailing Address - Zip Code:19979-1300
Mailing Address - Country:US
Mailing Address - Phone:302-270-8789
Mailing Address - Fax:
Practice Address - Street 1:4282 TURKEY POINT RD
Practice Address - Street 2:
Practice Address - City:VIOLA
Practice Address - State:DE
Practice Address - Zip Code:19979-1300
Practice Address - Country:US
Practice Address - Phone:302-270-8789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0036582163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool