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Individual

CRISTI L GODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1609 NORMAN DR, STE A-1, VALDOSTA, GA 31601-3753
(229) 245-1004
Mailing address
1609 NORMAN DR, STE A-1, VALDOSTA, GA 31601-3753
(229) 245-1004

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN130256
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1407824832
NPI
05
305457800
FL
05
978745311A
GA
Enumeration date
03/10/2006
Last updated
01/13/2016
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