Individual
MRS. JENNIFER GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1500 LINE AVE, SHREVEPORT, LA 71101-4639
(318) 629-5555
Mailing address
1500 LINE AVE STE 200, SHREVEPORT, LA 71101-4643
(318) 629-5555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
218490
LA
363LF0000X
Family Nurse Practitioner
218490
LA
Other
Enumeration date
01/29/2021
Last updated
03/30/2026
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