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1265186761
LAVANIESHA JACKSON GOODE
BRENTWOOD, NY
NPI
1265186761
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 734590)
Enumeration Date
2022-02-04
Last Update Date
2022-02-04
Business Address
LAVANIESHA JACKSON GOODE
24 MORRIS ST
BRENTWOOD, NY 11717-2609
Phone number: 631-601-3699
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Mailing Address
LAVANIESHA JACKSON GOODE
24 MORRIS ST
BRENTWOOD, NY 11717-2609
Phone number: 631-601-3699
Copy
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