Healthcare Provider Details

I. General information

NPI: 1558290635
Provider Name (Legal Business Name): SKY JA'NAE GOODWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SKY JA'NAE GREENWOOD

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 WILLIAMS DR STE 301
MURFREESBORO TN
37129-3195
US

IV. Provider business mailing address

1510 HUNTINGTON DR APT Z5
MURFREESBORO TN
37130-2240
US

V. Phone/Fax

Practice location:
  • Phone: 615-653-4115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: