Provider Demographics
NPI:1487330031
Name:GOODRICK, VICTOR (APRN)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:GOODRICK
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-525-5277
Mailing Address - Fax:
Practice Address - Street 1:720 COOL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2626
Practice Address - Country:US
Practice Address - Phone:855-950-5035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33928363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health