Most Relevant Information
Provider Data
| NPI Number: | 1003306267 |
| Provider Name: | KAWANA GOODMAN LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 5179299 |
Most Important Dates
| Enumeration Date: | 05/14/2018 |
| Last Updated: | 05/14/2018 |
Provider Practice Location
8216 PEAR RD
JACKSONVILLE
FL
322103474
Practice Location Phone/Fax
| Phone: | 9044460318 |
| Fax: |
Provider Mailing Location
8216 PEAR RD
JACKSONVILLE
FL
322103474
Provider Mailing Phone/Fax
| Phone: | 9044460318 |
| Fax: |