Provider Demographics
NPI:1376359976
Name:GOOCH, JOSHUA FRANKLIN (RN)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:FRANKLIN
Last Name:GOOCH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9142
Mailing Address - Country:US
Mailing Address - Phone:870-860-5214
Mailing Address - Fax:
Practice Address - Street 1:19 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542-9142
Practice Address - Country:US
Practice Address - Phone:870-860-5214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR087606163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse