Individual
JOHNNIE N BRADLEY-GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP - BC
Contact information
Practice address
84 W LOWDER ST, MACCLENNY, FL 32063-2638
(352) 374-5615
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APRN9215272
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP9215272
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9215272
FL
Other
Enumeration date
07/18/2018
Last updated
06/06/2023
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