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General NPI Number Information
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NPI Number | 1750959318
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Entity Type | Organization
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Legal Business Name | GOOD HEALTH CLINIC PROFESSIONAL LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 199 W PETTY LN
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City | WINCHESTER
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State | TN
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Zip | 37398-1128
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Country | US
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Telephone | 931-213-3976
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Fax | 931-281-3976
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Provider Business Mailing Address
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Address Line | 515 BILLY GOAT HILL RD
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City | WINCHESTER
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State | TN
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Zip | 37398-4951
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Country | US
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Telephone | 931-213-3976
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Fax |
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Authorized Official
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Title or Position | NP
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Name | KATIE GOODMAN HILL
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Credential | FNP-BC
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Telephone | 931-691-0399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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