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General NPI Number Information
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NPI Number | 1972511871
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Entity Type | Organization
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Legal Business Name | GOOD WILL INSTITUTE FOR HEALTH SERVICES INC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 08/28/2011
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Provider Practice Location Address
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Address Line | 304 W HONORS POINT CT
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City | SLIDELL
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State | LA
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Zip | 70458-5774
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Country | US
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Telephone | 504-606-6075
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Fax | 985-781-8065
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Provider Business Mailing Address
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Address Line | 304 W HONORS POINT CT
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City | SLIDELL
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State | LA
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Zip | 70458-5774
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Country | US
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Telephone | 504-606-6075
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Fax | 985-781-8065
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIE W ROBINSON
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Credential | APRN, NP-C
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Telephone | 504-606-6075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP06547
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License Number State | LA
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