Provider Demographics
NPI:1205092673
Name:GOODMAN, JOANNE H (RN)
Entity type:Individual
Prefix:MISS
First Name:JOANNE
Middle Name:H
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14867-9405
Mailing Address - Country:US
Mailing Address - Phone:607-564-6034
Mailing Address - Fax:
Practice Address - Street 1:314 BRAND ST APT A
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904-1467
Practice Address - Country:US
Practice Address - Phone:607-333-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264663164W00000X
NY755648163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse