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Mr. Kim Dale Goodrum, RN
Psychiatric/Mental Health Registered Nurse in Modesto, California
NPI 1558520114

Kim Dale Goodrum is a Psychiatric/Mental Health Registered Nurse based in Modesto, CA and is specialized in Psychiatric/Mental Health. Kim Dale Goodrum practices in Modesto, CA and has the professional credentials of RN. The NPI Number for Kim Dale Goodrum is 1558520114 and holds a License No. 696742 (California).

The current practice location address for Kim Dale Goodrum is 825 Palmilla Dr, Modesto, CA and can be reached out via phone at 209-572-3243.

Location: 825 Palmilla Dr, Modesto, CA, 95356-1152
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558520114
Provider Name
Kim Dale Goodrum
Credential
RN
Provider Entity Type
Individual
Gender
Male
Address
825 Palmilla Dr, Modesto, CA, 95356-1152
Phone Number
209-572-3243
Fax Number
Provider Enumeration Date
06/08/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
825 Palmilla Dr
City
Modesto
State
California
Zip
95356-1152
Phone Number
209-572-3243
Fax Number
person
Provider Business Mailing Address Details
Address
825 Palmilla Dr
City
Modesto
State
California
Zip
95356-1152
Phone Number
209-572-3243
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health
Taxonomy
163WP0808X
License No.
696742 (California)
Definition
Definition to come...
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