Individual
MISS PAMELA GODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4511 JACKSON ST # 4511, MARIANNA, FL 32448-4718
(850) 557-6783
Mailing address
4511 JACKSON ST # 4511, MARIANNA, FL 32448-4718
(850) 557-6783
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
FL
376K00000X
Nurse's Aide
Primary
—
FL
376K00000X
Nurse's Aide
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721310
—
FL
Enumeration date
07/26/2018
Last updated
07/26/2018
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