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Individual

MR. JASON R. GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
(970) 472-9381
Mailing address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
(970) 472-9381

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
121533
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117082100
WY
05
52909361
CO
Enumeration date
10/11/2005
Last updated
02/18/2011
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