Provider Demographics
NPI:1710918800
Name:GOODWIN, JANET TERESE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:TERESE
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-6032
Mailing Address - Country:US
Mailing Address - Phone:402-991-6921
Mailing Address - Fax:
Practice Address - Street 1:913 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-6032
Practice Address - Country:US
Practice Address - Phone:402-991-6921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22893208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics