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Individual

KAWANA GOODMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
8216 PEAR RD, JACKSONVILLE, FL 32210-3474
(904) 446-0318
Mailing address
8216 PEAR RD, JACKSONVILLE, FL 32210-3474
(904) 446-0318

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5179299
FL

Other

Enumeration date
05/14/2018
Last updated
05/14/2018
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