Individual
HOLLY ELIZABETH GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2064 VINEVILLE AVE, MACON, GA 31204-3140
(478) 743-1478
Mailing address
6264 ROGERS RD, LIZELLA, GA 31052-5503
(478) 550-0605
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN264268
GA
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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