Individual
JERRI GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1515 N MADISON AVE, ANDERSON, IN 46011-3453
(317) 802-6302
Mailing address
PO BOX 68952, INDIANAPOLIS, IN 46268-0952
(317) 802-6302
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28120956
IN
Other
Enumeration date
11/18/2005
Last updated
10/31/2007
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