ANDREA ANNMARIE GOULBOURNE-SMITH APRN PMHNP-BC NPI 1003397944

NPI Information

NPI: 1003397944
Provider Name: ANDREA ANNMARIE GOULBOURNE-SMITH, APRN, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
7369 SHERIDAN ST STE 101
HOLLYWOOD, FL
ZIP 33024
Phone: (954) 561-6222
Get Directions

Andrea Annmarie Goulbourne-smith, APRN, PMHNP-BC is a psychiatric/mental health nurse practitioner in Hollywood, FL with 7 years of experience. Andrea Annmarie Goulbourne-smith, APRN, PMHNP-BC NPI is 1003397944. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7369 SHERIDAN ST STE 101
HOLLYWOOD, FL
ZIP 33024-776
Phone: (954) 561-6222
Fax: (954) 990-7650

The NPI 1003397944 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/28/2018 and was last updated on 1/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	2935672	FLORIDA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APRN2935672	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	109518100	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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