Individual provider · Type 1 NPI

Christina Goodman, PA

Medical Physician Assistant · Rexburg, ID

NPI number 1780691394 Active

Practice location

100 Student Health Center Building
Rexburg, ID 83440

Call (208) 496-1300 Map

Fax (208) 496-1306

Mailing address

490 Pioneer Rd Apt 1204
Rexburg, ID 83440-3799

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA591 (ID)

Medical Physician Assistant: Definition to come...

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About NPI 1780691394

Christina Goodman, PA's National Provider Identifier is 1780691394, issued on Aug 3, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Rexburg, ID. The record was last updated on Jul 8, 2007.