Individual
MS. SHENAVIAN FREDITA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1601 DUNN AVE APT 504, JACKSONVILLE, FL 32218-4737
(904) 379-4931
Mailing address
1601 DUNN AVE APT 504, JACKSONVILLE, FL 32218-4737
(904) 379-4931
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5154281
FL
Other
Enumeration date
04/19/2007
Last updated
12/09/2008
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