Provider Demographics
NPI:1922402726
Name:GOODIN, JEANINE (MSN, APRN, CNP, CNRN)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:GOODIN
Suffix:
Gender:F
Credentials:MSN, APRN, CNP, CNRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 VINE STREET
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45221-0038
Mailing Address - Country:US
Mailing Address - Phone:513-558-2930
Mailing Address - Fax:
Practice Address - Street 1:7125 TRESSEL WOOD DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-1912
Practice Address - Country:US
Practice Address - Phone:513-314-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP020768363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily