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Individual

JONATHAN PERRY GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
4110 S 100TH EAST AVE STE 201, TULSA, OK 74146-3629
(918) 857-7246
(918) 359-5828
Mailing address
4110 S 100TH EAST AVE STE 201, TULSA, OK 74146-3629
(918) 857-7246
(918) 359-5828

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
R0129507
OK
363LF0000X
Family Nurse Practitioner
Primary
201903
OK

Other

Enumeration date
01/14/2021
Last updated
12/10/2025
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