Provider Demographics
NPI:1801608682
Name:GOODNIGHT, KRISTA TAYLOR
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:TAYLOR
Last Name:GOODNIGHT
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 1:18230 TWIN FALLS LN
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-1844
Mailing Address - Country:US
Mailing Address - Phone:804-402-2412
Mailing Address - Fax:
Practice Address - Street 1:18230 TWIN FALLS LN
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-1844
Practice Address - Country:US
Practice Address - Phone:804-402-2412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer