Individual
COURTNEY DANIELLE GOODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1630 GOODMAN RD E STE 3, SOUTHAVEN, MS 38671-9556
(901) 821-1123
Mailing address
PO BOX 342322, BARTLETT, TN 38184-2322
(662) 470-7232
(502) 568-7136
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A810522
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
APN0000017234
TN
363LF0000X
Family Nurse Practitioner
17234
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810522
BOARD OF NURSING
MS
Enumeration date
02/07/2013
Last updated
06/11/2025
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