Provider Demographics
NPI:1588543847
Name:MCGOODWIN, MOLLY (RN)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:MCGOODWIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1400 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GYPSUM
Mailing Address - State:CO
Mailing Address - Zip Code:81637-8602
Mailing Address - Country:US
Mailing Address - Phone:214-536-6000
Mailing Address - Fax:
Practice Address - Street 1:1400 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:GYPSUM
Practice Address - State:CO
Practice Address - Zip Code:81637-8602
Practice Address - Country:US
Practice Address - Phone:214-536-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1682523163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse