Provider Demographics
NPI:1962269738
Name:GODSEY, KRISTEN (RN, FNP-STUDENT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:GODSEY
Suffix:
Gender:F
Credentials:RN, FNP-STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5277 BELL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:APISON
Mailing Address - State:TN
Mailing Address - Zip Code:37302-9537
Mailing Address - Country:US
Mailing Address - Phone:417-838-7688
Mailing Address - Fax:
Practice Address - Street 1:5277 BELL RIDGE DR
Practice Address - Street 2:
Practice Address - City:APISON
Practice Address - State:TN
Practice Address - Zip Code:37302-9537
Practice Address - Country:US
Practice Address - Phone:417-838-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN195857163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse