Basic Information
Provider Information
NPI: 1831819580
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GODFREY
FirstName: SHEILA
MiddleName: FRANCES
NamePrefix: MRS.
NameSuffix:  
Credential: CPNP-PC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 36 POKANOKET LN
Address2:  
City: MARSHFIELD
State: MA
PostalCode: 020508226
CountryCode: US
TelephoneNumber: 7812581201
FaxNumber:  
Practice Location
Address1: 30 WARREN ST
Address2:  
City: BRIGHTON
State: MA
PostalCode: 021353602
CountryCode: US
TelephoneNumber: 6172543800
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/01/2022
LastUpdateDate: 09/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XRN177848MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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