Provider Demographics
NPI:1902697303
Name:GOODFHOUSE, BERNICE DENISE
Entity type:Individual
Prefix:
First Name:BERNICE
Middle Name:DENISE
Last Name:GOODFHOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW ROCKFORD
Mailing Address - State:ND
Mailing Address - Zip Code:58356-1803
Mailing Address - Country:US
Mailing Address - Phone:701-230-0810
Mailing Address - Fax:
Practice Address - Street 1:231 1ST AVE N
Practice Address - Street 2:
Practice Address - City:NEW ROCKFORD
Practice Address - State:ND
Practice Address - Zip Code:58356-1803
Practice Address - Country:US
Practice Address - Phone:701-230-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker