Provider Demographics
NPI:1952298770
Name:DRAGONY-GOFF, NICOLETTE (APRN)
Entity type:Individual
Prefix:
First Name:NICOLETTE
Middle Name:
Last Name:DRAGONY-GOFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1497 W UNIVERSITY HEIGHTS DR N
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-8971
Mailing Address - Country:US
Mailing Address - Phone:707-334-3626
Mailing Address - Fax:
Practice Address - Street 1:1895 N JASPER DR STE 3
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1632
Practice Address - Country:US
Practice Address - Phone:928-913-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTEMP325730363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care