Provider Demographics
NPI:1205412566
Name:GOINS, IRENE
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:GOINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7260 CROSS COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:MINERAL
Mailing Address - State:VA
Mailing Address - Zip Code:23117-2829
Mailing Address - Country:US
Mailing Address - Phone:804-762-3030
Mailing Address - Fax:
Practice Address - Street 1:7260 CROSS COUNTY RD
Practice Address - Street 2:
Practice Address - City:MINERAL
Practice Address - State:VA
Practice Address - Zip Code:23117-2829
Practice Address - Country:US
Practice Address - Phone:804-762-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker