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Individual

DR. CHRISTA CHEYENNE GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1103 S US HIGHWAY 169, SMITHVILLE, MO 64089-9322
(816) 691-5340
(816) 346-7054
Mailing address
1103 S US HIGHWAY 169, SMITHVILLE, MO 64089-9322
(816) 691-5340
(816) 346-7054

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2018020725
MO
207Q00000X
Family Medicine Physician
Primary
2020038020
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487159976
MO
Enumeration date
03/27/2018
Last updated
11/09/2021
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