Individual
DARA NICOLE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
543 JONESBORO RD, MCDONOUGH, GA 30253-3718
(678) 583-9071
Mailing address
543 JONESBORO RD, MCDONOUGH, GA 30253-3718
(678) 583-9071
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN180693
GA
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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