Individual
MS. KATHLEEN A GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2401 HAINE DR, HARLINGEN, TX 78550-8592
(956) 412-2400
(956) 412-2404
Mailing address
2401 HAINE DR, HARLINGEN, TX 78550-8592
(956) 412-2400
(956) 412-2404
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
655955
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088283903
—
TX
01
—
423613
MEDICARE PTAN
TX
01
—
BCBS
NP7106
TX
Enumeration date
12/12/2006
Last updated
11/11/2015
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