IndividualActive
Adam Goforth
NPI 1356173124 · Psychiatric/Mental Health Nurse Practitioner · Anna, IL
Provider details
- NPI number
- 1356173124
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 209.030398 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Practice location
513 N Main St
Anna, IL 62906-1697
Phone: (618) 833-4471
Approximate (ZIP-level) locationGet directions
Mailing address
513 N Main St
Anna, IL 62906-1668
Registry dates
- Enumerated
- 2024-08-19
- Last updated
- 2024-12-09
- Certified
- 2024-11-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.