Provider Demographics
NPI:1821566019
Name:GODOY, RACHEAL RENEE (MSN, RN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:RACHEAL
Middle Name:RENEE
Last Name:GODOY
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 AUBURN PL
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-4906
Mailing Address - Country:US
Mailing Address - Phone:432-853-4551
Mailing Address - Fax:
Practice Address - Street 1:2400 AUBURN PL
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-4906
Practice Address - Country:US
Practice Address - Phone:432-853-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty