Healthcare Provider Details

I. General information

NPI: 1265002307
Provider Name (Legal Business Name): ARYN LEA GOODWIN DNP, FNP-BC, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8777 W FOREST HOME AVE
GREENFIELD WI
53228-3421
US

IV. Provider business mailing address

1130 COLLINS RD
JEFFERSON WI
53549-2939
US

V. Phone/Fax

Practice location:
  • Phone: 414-231-3130
  • Fax:
Mailing address:
  • Phone: 920-674-3170
  • Fax: 445-999-5695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10386-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: