Healthcare Provider Details

I. General information

NPI: 1962232363
Provider Name (Legal Business Name): ALEXANDRIA GOODWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HIGHWAY 70 E FL 3
DICKSON TN
37055-2075
US

IV. Provider business mailing address

127 CRESTVIEW PARK DR
DICKSON TN
37055-2855
US

V. Phone/Fax

Practice location:
  • Phone: 615-441-4435
  • Fax: 615-444-4457
Mailing address:
  • Phone: 615-446-2708
  • Fax: 615-446-1380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number36667
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: