Healthcare Provider Details

I. General information

NPI: 1750711628
Provider Name (Legal Business Name): JACQUELINE D'AMICO GOOD PPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5007 STARBOARD ST # 7
CHRISTIANSTED VI
00820-4676
US

IV. Provider business mailing address

PO BOX 4459
KINGSHILL VI
00851-4459
US

V. Phone/Fax

Practice location:
  • Phone: 340-202-1997
  • Fax: 561-516-6500
Mailing address:
  • Phone: 340-202-1997
  • Fax: 561-516-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP13889
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: