Provider Demographics
NPI:1386101251
Name:GODEK, KATHERINE FIRTH (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:FIRTH
Last Name:GODEK
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:GRACE
Other - Last Name:FIRTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-693-2100
Mailing Address - Fax:603-679-1046
Practice Address - Street 1:96 CALEF HWY
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2224
Practice Address - Country:US
Practice Address - Phone:603-693-2100
Practice Address - Fax:603-679-1046
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH058219-23363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3116491Medicaid