Provider Demographics
NPI:1194484469
Name:GOINS, ANGELA RENEE (REGISTERED NURS, CCM)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:RENEE
Last Name:GOINS
Suffix:
Gender:F
Credentials:REGISTERED NURS, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2937 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-4105
Mailing Address - Country:US
Mailing Address - Phone:865-235-6804
Mailing Address - Fax:
Practice Address - Street 1:2937 JOHNSTON RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:TN
Practice Address - Zip Code:37777-4105
Practice Address - Country:US
Practice Address - Phone:865-235-6804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN77025163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management