Provider Demographics
NPI:1982430294
Name:GOOCH, VANDI (MHA, MSN, APRN-CNP)
Entity type:Individual
Prefix:
First Name:VANDI
Middle Name:
Last Name:GOOCH
Suffix:
Gender:
Credentials:MHA, MSN, APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 KEYSTONE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-2229
Mailing Address - Country:US
Mailing Address - Phone:812-449-6848
Mailing Address - Fax:270-957-8797
Practice Address - Street 1:1305 N ELM ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2783
Practice Address - Country:US
Practice Address - Phone:270-957-8800
Practice Address - Fax:270-957-8797
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28187478A163W00000X
IN28187478C163W00000X
KY4026764363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily