Provider Demographics
NPI:1720582026
Name:GODFREY, ZAKISHA A (NP, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:ZAKISHA
Middle Name:A
Last Name:GODFREY
Suffix:
Gender:F
Credentials:NP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1530
Mailing Address - Country:US
Mailing Address - Phone:508-562-0792
Mailing Address - Fax:
Practice Address - Street 1:288 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1820
Practice Address - Country:US
Practice Address - Phone:781-447-6425
Practice Address - Fax:781-447-1786
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN267092163W00000X
GA247546163W00000X, 363LP0808X
FL11015369363LP0808X
MA267092363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse