Kelly A Goddard
Specialist/Technologist, Athletic Trainer in Stratford, Connecticut
1700540200- Practice location
- 201 Nichols Ter, Stratford, CT 06614-3959
- Phone
- 203-377-1752
- Fax
- —
- Last updated
- June 2, 2024
Kelly Amanda Goddard is a Specialist/Technologist, Athletic Trainer based in Stratford, CT. Kelly Amanda Goddard practices in Stratford, CT. The NPI Number for Kelly Amanda Goddard is 1700540200 and holds a License No. 1851 (CT). The current practice location address for Kelly Amanda Goddard is 201 Nichols Ter, Stratford, CT 06614-3959 and can be reached out via phone at 203-377-1752.
Provider Profile Details
- NPI Number
- 1700540200
- Provider Name
- Kelly Amanda Goddard
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 201 Nichols Ter, Stratford, CT 06614-3959
- Phone Number
- 203-377-1752
- Primary Taxonomy
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 29, 2021
- Last Update Date
- June 2, 2024
- Certification Date
- June 2, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 201 Nichols Ter
Stratford, CT 06614-3959 - City
- Stratford
- State
- Connecticut
- Zip
- 06614-3959
- Phone Number
- 203-377-1752
Provider Business Mailing Address Details
- Address
- 201 Nichols Ter
Stratford, CT 06614-3959 - City
- Stratford
- State
- CT
- Zip
- 06614-3959
- Phone Number
- 203-377-1752
License Information
- License Number (1)
- 1851
- License State (1)
- CT
- Taxonomy (1)
- Specialist/Technologist, Athletic Trainer · 2255A2300X · Primary
- License State (2)
- CT
- Taxonomy (2)
- Student in an Organized Health Care Education/Training Program · 390200000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kelly A Goddard?
The NPI number of Kelly A Goddard is 1700540200. It was assigned on October 29, 2021 and is currently active in the NPPES registry.
What is the specialty of Kelly A Goddard?
Kelly A Goddard is registered under the primary taxonomy Specialist/Technologist, Athletic Trainer (code 2255A2300X), licensed in CT under license number 1851.
Where does Kelly A Goddard practice?
The practice location is 201 Nichols Ter, Stratford, CT 06614-3959. The office can be reached at 203-377-1752 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1700540200 directly on the NPPES registry website.