Provider Demographics
NPI:1750959318
Name:GOOD HEALTH CLINIC PROFESSIONAL LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:GOOD HEALTH CLINIC PROFESSIONAL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN HILL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:931-691-0399
Mailing Address - Street 1:515 BILLY GOAT HILL RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-4951
Mailing Address - Country:US
Mailing Address - Phone:931-213-3976
Mailing Address - Fax:
Practice Address - Street 1:199 W PETTY LN
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-1128
Practice Address - Country:US
Practice Address - Phone:931-213-3976
Practice Address - Fax:931-281-3976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty