Provider Demographics
NPI:1952630071
Name:GOODWIN, HALIMA JOSINA (DNP, CPNP-PC, PMHNP)
Entity Type:Individual
Prefix:
First Name:HALIMA
Middle Name:JOSINA
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 JUAN TABO BLVD NE STE 2B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2691
Mailing Address - Country:US
Mailing Address - Phone:505-550-1011
Mailing Address - Fax:505-207-5377
Practice Address - Street 1:5203 JUAN TABO BLVD NE STE 2B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2691
Practice Address - Country:US
Practice Address - Phone:505-550-1011
Practice Address - Fax:505-207-5377
Is Sole Proprietor?:No
Enumeration Date:2009-12-19
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN968478363LP0200X
TX85401363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics