Individual
MS. JORDAN ELYSE GOODIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2018023543
MO
363LF0000X
Family Nurse Practitioner
Primary
2024005871
MO
Other
Enumeration date
01/08/2024
Last updated
02/15/2024
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