Provider Demographics
NPI:1982396883
Name:GOODSON, PAULA (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:GOODSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 LAKEMONT RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1249
Mailing Address - Country:US
Mailing Address - Phone:443-520-3547
Mailing Address - Fax:
Practice Address - Street 1:1020 LAKEMONT RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1249
Practice Address - Country:US
Practice Address - Phone:443-520-3547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR215962163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse