Individual provider · Type 1 NPI
Timika Shante Goodson, FNP-C, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Upper Marlboro, MD
NPI number
1053910794
Active
Practice location
3421 Gentle Breeze Dr # A
Upper Marlboro, MD 20772-2549
Fax (240) 306-9503
Mailing address
3421 Gentle Breeze Dr
Upper Marlboro, MD 20772-2549
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN1055089 (DC) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN1055089 (DC) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | R228537 (MD) |
| Family Nurse Practitioner | 363LF0000X | R228537 (MD) |
| Community Health Registered Nurse | 163WC1500X | RN1055089 (DC) |
| Home Health Registered Nurse | 163WH0200X | R228537 (MD) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1053910794
Timika Shante Goodson, FNP-C, PMHNP-BC's National Provider Identifier is 1053910794, issued on Oct 23, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Upper Marlboro, MD. The record was last updated on Jan 30, 2024.