Provider Demographics
NPI:1780141986
Name:GODOY, CATHERINE ELAINE (APRN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELAINE
Last Name:GODOY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2130 HOPKINS ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5220
Mailing Address - Country:US
Mailing Address - Phone:904-779-0941
Mailing Address - Fax:
Practice Address - Street 1:611 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-2847
Practice Address - Country:US
Practice Address - Phone:904-358-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-23
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001392163WP0808X
FLAPRN11001392363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health