Provider Demographics
NPI:1447048335
Name:GOODIN, GERALDA B (FNP-C)
Entity type:Individual
Prefix:
First Name:GERALDA
Middle Name:B
Last Name:GOODIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:GERALDA
Other - Middle Name:B
Other - Last Name:DA SILVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:743 MILLER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1813
Mailing Address - Country:US
Mailing Address - Phone:928-777-9600
Mailing Address - Fax:855-449-5560
Practice Address - Street 1:743 MILLER VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1813
Practice Address - Country:US
Practice Address - Phone:928-777-9600
Practice Address - Fax:855-449-5560
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ322813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily