Individual provider · Type 1 NPI
Anna Hazel Goddard, APRN, CPNP-PC
Pediatric Nurse Practitioner · New London, CT
NPI number
1720194939
Active
Practice location
7 Vauxhall St, Child & Family Agency Of Sect, Inc.
New London, CT 06320-5711
Fax (860) 701-3776
Mailing address
255 Hempstead St
New London, CT 06320-6204
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 765853 (TX) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 3291 (CT) |
| Registered Nurse | 163W00000X | 73362 (CT) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1720194939
Anna Hazel Goddard, APRN, CPNP-PC's National Provider Identifier is 1720194939, issued on Aug 21, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in New London, CT. The record was last updated on Apr 5, 2016.