Provider Demographics
NPI:1801682471
Name:GOLDSBERRY, JENYPHR (RN)
Entity type:Individual
Prefix:
First Name:JENYPHR
Middle Name:
Last Name:GOLDSBERRY
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MILL WOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3698
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:204 MILL WOOD DR
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3698
Practice Address - Country:US
Practice Address - Phone:817-939-4281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX946266163WI0600X, 163WP2201X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care