Individual
MRS. ALICIA DORETHEA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4300B W RAILROAD ST, GULFPORT, MS 39501-2568
(228) 822-6722
Mailing address
3211 ROSEWOOD DR, HATTIESBURG, MS 39401-4517
(601) 631-1810
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906660
MS
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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