Provider Demographics
NPI:1396292017
Name:GOUDAS, NANCY AMBER (NP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:AMBER
Last Name:GOUDAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:AMBER
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 3710
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-3710
Mailing Address - Country:US
Mailing Address - Phone:828-324-9550
Mailing Address - Fax:828-324-4154
Practice Address - Street 1:2406 CENTURY PL SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4031
Practice Address - Country:US
Practice Address - Phone:828-324-9550
Practice Address - Fax:828-324-4154
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC500891363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily