| NPI | 1194197731 |
|---|---|
| Former Name | HEATHER LYNN GOODWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP015445) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: PA MD3716339) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2024-07-08 |