Provider Demographics
NPI:1841272358
Name:GOODMAN, LINDA A (NP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:A
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:184 HEATHERSTONE RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1669
Mailing Address - Country:US
Mailing Address - Phone:413-253-0049
Mailing Address - Fax:
Practice Address - Street 1:627 RANDALL RD.
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056
Practice Address - Country:US
Practice Address - Phone:413-585-0119
Practice Address - Fax:413-253-9767
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151079363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3306OtherBLUE CROSS
P34166Medicare UPIN
MANP3306OtherBLUE CROSS