Provider Demographics
NPI:1669770723
Name:GOODIN, THOMAS E IV (FNP)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:E
Last Name:GOODIN
Suffix:IV
Gender:M
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:555 KITCHINGS DR STE C
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-3576
Mailing Address - Country:US
Mailing Address - Phone:704-873-7012
Mailing Address - Fax:704-660-4164
Practice Address - Street 1:555 KITCHINGS DR STE C
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3576
Practice Address - Country:US
Practice Address - Phone:704-838-7080
Practice Address - Fax:704-660-4164
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5004735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily