Provider Demographics
NPI:1972116242
Name:GOODWIN, ADONIS CAROL (CRNP, AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ADONIS
Middle Name:CAROL
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:CRNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1380
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1380
Mailing Address - Country:US
Mailing Address - Phone:256-235-5121
Mailing Address - Fax:256-231-2831
Practice Address - Street 1:400 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4716
Practice Address - Country:US
Practice Address - Phone:256-235-5121
Practice Address - Fax:256-231-2831
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-145635363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care