Healthcare Provider Details

I. General information

NPI: 1295646487
Provider Name (Legal Business Name): JAIMI CHRISTINE GOODHEW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 TUCKERTON RD
TABERNACLE NJ
08088-9317
US

IV. Provider business mailing address

378 TUCKERTON RD
TABERNACLE NJ
08088-9317
US

V. Phone/Fax

Practice location:
  • Phone: 862-268-7670
  • Fax:
Mailing address:
  • Phone: 862-268-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN500022249
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: