Individual provider · Type 1 NPI
Mark A. Goforth, NURSE PRACTITIONER
Psychiatric/Mental Health Nurse Practitioner · Vail, AZ
NPI number
1699198747
Active
Practice location
14029 E Camino Galante
Vail, AZ 85641-2067
Mailing address
14029 E. Camino Galante
Vail, AZ 85641
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | AP4993 (AZ) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1699198747
Mark A. Goforth, NURSE PRACTITIONER's National Provider Identifier is 1699198747, issued on Jan 27, 2014. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Vail, AZ. The record was last updated on Aug 26, 2025.