Individual
JORDAN LEA GOAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1483 TOBIAS GADSON BLVD STE 107, CHARLESTON, SC 29407-4795
(843) 745-5153
(843) 766-8606
Mailing address
1065 NE 125TH ST STE 300, NORTH MIAMI, FL 33161-5833
(888) 852-6672
(305) 891-4228
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.21159
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN282704
GA
Other
Enumeration date
01/22/2019
Last updated
04/26/2021
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