Provider Demographics
NPI:1508747627
Name:GOODMAN, JOANNA KAY (NP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:KAY
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:MARXER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4179 S RIVERBOAT RD STE 220
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2986
Mailing Address - Country:US
Mailing Address - Phone:801-921-6276
Mailing Address - Fax:801-880-3566
Practice Address - Street 1:100 BROOKSHIRE BLVD UNIT 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6751
Practice Address - Country:US
Practice Address - Phone:406-702-1327
Practice Address - Fax:406-206-0105
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-267538363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily