Provider Demographics
NPI:1982400602
Name:GOODWIN, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 DOOLITTLE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-1139
Mailing Address - Country:US
Mailing Address - Phone:615-563-4062
Mailing Address - Fax:
Practice Address - Street 1:324 DOOLITTLE RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-1139
Practice Address - Country:US
Practice Address - Phone:615-563-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN142257163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse