Provider Demographics
NPI:1740093368
Name:SANDBERG-GOODNER, DONNA RAE
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:RAE
Last Name:SANDBERG-GOODNER
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 1:1317 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DESHLER
Mailing Address - State:NE
Mailing Address - Zip Code:68340-9881
Mailing Address - Country:US
Mailing Address - Phone:308-352-8482
Mailing Address - Fax:
Practice Address - Street 1:1317 3RD ST
Practice Address - Street 2:
Practice Address - City:DESHLER
Practice Address - State:NE
Practice Address - Zip Code:68340-9881
Practice Address - Country:US
Practice Address - Phone:308-352-8482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant