Provider Demographics
NPI:1487204277
Name:GODWIN, KASMINE J (LPN)
Entity Type:Individual
Prefix:MS
First Name:KASMINE
Middle Name:J
Last Name:GODWIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KASMINE
Other - Middle Name:J
Other - Last Name:GODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2706 SAWMILL PARK DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1871
Mailing Address - Country:US
Mailing Address - Phone:614-745-4641
Mailing Address - Fax:
Practice Address - Street 1:2706 SAWMILL PARK DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1871
Practice Address - Country:US
Practice Address - Phone:614-745-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH168069164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse