Individual
JESSICA GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
458 BEAR CT, SAINT PAUL, MN 55127-1004
(612) 558-3031
Mailing address
458 BEAR CT, SAINT PAUL, MN 55127-1004
(612) 558-3031
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2547694
MN
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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