Provider Demographics
NPI:1184972408
Name:GOODWIN, SHERI ANNE (MSC)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:ANNE
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 SPRING GLEN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5916
Mailing Address - Country:US
Mailing Address - Phone:855-246-6394
Mailing Address - Fax:855-246-6394
Practice Address - Street 1:3107 SPRING GLEN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5916
Practice Address - Country:US
Practice Address - Phone:855-246-6394
Practice Address - Fax:855-246-6394
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator