Individual
TERRA R GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
240 COLONIAL CIR, SUITE A, JAMESTOWN, TN 38556-3924
(931) 646-7578
(931) 879-9938
Mailing address
240 COLONIAL CIR, SUITE A, JAMESTOWN, TN 38556-3924
(931) 646-7578
(931) 879-9938
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000060426
TN
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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