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NPI Code Detail

MEDICARE: LISA GOODWIN

MEDICARE:   LISA  GOODWIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372500000XChore ProviderNV
2372600000XAdult CompanionNV
33747A0650XAttendant Care ProviderNV
4376J00000XHomemakerNV
53747P1801XPersonal Care AttendantNV

General Provider Information

NPI Number : 1669973772
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA GOODWIN
Provider Business Mailing Address
First Line : 4240 EL MOOR WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-6407
Country : US
Telephone Number : 702-813-7277
Fax Number :
Provider Business Practice Location Address
First Line : 7320 SMOKE RANCH RD STE H
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0259
Country : US
Telephone Number : 702-380-0600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2018
Last Update Date : 02/23/2018

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Directions to “ LISA GOODWIN ” Practice Location

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