Individual
SARA GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8233 GLENCARIN BLVD, FORT WAYNE, IN 46804-5784
(260) 425-5470
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
28252299A
IN
363L00000X
Nurse Practitioner
Primary
71015409A
IN
Other
Enumeration date
04/30/2024
Last updated
01/08/2025
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