Individual
MS. AMANDA J GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2880 S 99TH ST, WEST ALLIS, WI 53227-3363
(312) 209-1554
Mailing address
2880 S 99TH ST, WEST ALLIS, WI 53227-3363
(312) 209-1554
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
251400-30
WI
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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