Individual
MS. SHENETTA GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P
Contact information
Practice address
3502 W NORTHSIDE DRIVE, JACKSON, MS 39213-3467
(601) 364-5130
Mailing address
3502 W NORTHSIDE DRIVE, JACKSON, MS 39213-2617
(601) 364-5130
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R864623
MS
Other
Enumeration date
01/14/2012
Last updated
08/12/2013
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