STACIA LAROSE GODBOLDT

ST AUGUSTINE, FL
NPI1356040018
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy367A00000X Advanced Practice Midwife
Enumeration Date2023-03-01
Last Update Date2023-03-02
Business Address
STACIA LAROSE GODBOLDT CNM
300 HEALTH PARK BLVD STE 3002
ST AUGUSTINE, FL 32086-3703
Phone number: 904-819-1500
Mailing Address
STACIA LAROSE GODBOLDT CNM
184 OAK SHADOW PL
SAINT JOHNS, FL 32259-7425
Phone number: 904-652-7298