MRS. STEPHANNIE LORENE GOODRUM (NPI# 1700396405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700396405 |
| Entity Type | Individual |
| Full Name | MRS. STEPHANNIE LORENE GOODRUM |
| Credential | APRN |
| Practice Address |
308 S Washington St Ste 200 Clinton KY 42031-1347 |
| Mailing Address |
175 Evans Ln Clinton KY 42031-9402 |
| Practice Telephone | 2706530220 |
| Practice Fax Number | 2706530221 |
| Mailing Telephone | 2702179558 |
| Enumeration Date | 2017-10-07 |
| Last Update Date | 2017-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3011787 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
308 S WASHINGTON ST STE 200 |
| City | CLINTON |
| State | KY |
| Zip Code | 42031-1347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639680846 | Amy Marie Turner | Nurse Practitioner | 308 S Washington St Ste 200, Clinton, KY 42031-1347 | 2017-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780102301 | Communtiy Healthcare of Western Kentucky LLC | Clinic/Center | 308 South Washington Street Suite 200, Clinton, KY 42031 | 2017-09-04 |
| 1053569442 | Hickman County High School Clinic | Public Health or Welfare | 301 East Cresap Street, Clinton, KY 42031 | 2008-08-28 |
| 1437186657 | Purchase District Health Dept | Public Health or Welfare | 370 S Washington Street, Clinton, KY 42031 | 2006-06-26 |
| 1104800101 | Arbor Place of Clinton | Skilled Nursing Facility | 106 Padgett Drive, Clinton, KY 42031 | 2005-12-02 |
| 1902954118 | Clinton-hickman County Ambulance Service Inc | Ambulance | 324 James H Phillips Dr, Clinton, KY 42031-0083 | 2007-01-07 |
| 1568902427 | Clinton Pharmacy LLC | Pharmacy | 119 E Clay St, Clinton, KY 42031-1222 | 2017-02-26 |
| 1932131356 | Byassee Drug Company Inc | Durable Medical Equipment & Medical Supplies | 107 E Clay St, Clinton, KY 42031-1222 | 2006-07-07 |
| 1174087647 | Clinton Pharmacy LLC | Pharmacy | 119 E Clay St, Clinton, KY 42031-1222 | 2019-01-29 |
| 1205048873 | John Garland Byassee | Pharmacist | 107 E Clay St, Clinton, KY 42031-1222 | 2007-05-04 |
| 1275617755 | Perkins Pharmacy | Durable Medical Equipment & Medical Supplies | 119 E Clay St, Clinton, KY 42031-1222 | 2006-10-24 |
| Find all providers in zip 42031 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463300 | Sheryl Punzal Deguzman-buenaventura | Nurse Practitioner | 12410 Hillantrae Dr, Clinton, MD 20735-6510 | 2020-09-25 |
| 1003426396 | Rollie Stewart Walker | Nurse Practitioner | 114 Riverview Dr, Clinton, OK 73601-1805 | 2020-08-03 |
| 1316585813 | Sherkeysha Henderson | Nurse Practitioner | 106 Rosalie Ct, Clinton, MS 39056-6053 | 2019-12-16 |
| 1528600707 | Allison Maddox | Nurse Practitioner | 7506 Abelia Dr, Clinton, MD 20735-3135 | 2019-10-09 |
| 1205486347 | Elizabeth Oti | Nurse Practitioner | 313 Park Edge Dr, Clinton, PA 15026-1785 | 2019-09-19 |
| 1326609074 | Lauren Blakley | Nurse Practitioner | 2130 N Charles G Seivers Blvd Ste 3, Clinton, TN 37716-6705 | 2019-06-24 |
| 1346807443 | Karen Daniels | Nurse Practitioner | 2701 Frienship Trl, Apt 1001, Clinton, IA 52732 | 2019-05-23 |
| 1205490380 | Cynthia Diane Saylors | Nurse Practitioner | 64 Somerset Dr, Clinton, IL 61727-2478 | 2019-04-24 |
| 1720546864 | Lesley Brooke Keith | Nurse Practitioner | 422 Highway 95 E, Clinton, AR 72031-6947 | 2019-03-07 |
| 1578020822 | Caroline V Green | Nurse Practitioner | 768 Cherry Stone Dr, Clinton, MS 39056-2015 | 2019-02-22 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.