Provider Demographics
NPI:1689292526
Name:GOLDSMITH, KEDISHA MAURAINE (CNA)
Entity Type:Individual
Prefix:MRS
First Name:KEDISHA
Middle Name:MAURAINE
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6088 DAVON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-3178
Mailing Address - Country:US
Mailing Address - Phone:754-242-1551
Mailing Address - Fax:
Practice Address - Street 1:6088 DAVON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-3178
Practice Address - Country:US
Practice Address - Phone:754-242-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker