Provider Demographics
NPI:1750852125
Name:GOOD, CARA LYNN (LPN)
Entity type:Individual
Prefix:MISS
First Name:CARA
Middle Name:LYNN
Last Name:GOOD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2122
Mailing Address - Country:US
Mailing Address - Phone:740-294-3595
Mailing Address - Fax:
Practice Address - Street 1:418 S 7TH ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2122
Practice Address - Country:US
Practice Address - Phone:740-294-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.167954.MED-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse