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Individual

MRS. CARRIE BETH GOODMAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
L.P.N.

Contact information

Practice address
2352 N 70TH ST, WAUWATOSA, WI 53213-1320
(414) 257-3163
Mailing address
W262S3172 VIEW DR, WAUKESHA, WI 53189-6320
(262) 547-9119

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
WI

Other

Enumeration date
03/17/2006
Last updated
07/08/2007
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