Individual
JENNIFER M GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP C
Contact information
Practice address
1330 CEDAR LN STE 900 BLDG B, TULLAHOMA, TN 37388-2286
(931) 455-2674
(931) 455-8983
Mailing address
PO BOX 1327, 1330 CEDAR LANE BLDG B SUITE 900, TULLAHOMA, TN 37388-1327
(931) 455-2674
(931) 455-8983
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN11120
TN
363LP0200X
Pediatric Nurse Practitioner
APN11120
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1504384
—
TN
Enumeration date
04/23/2007
Last updated
05/14/2014
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