Provider Demographics
NPI:1043841588
Name:GOODWIN, BRITTANY NICHOLE (LVN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICHOLE
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 N KNOLL APT 1408
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2257
Mailing Address - Country:US
Mailing Address - Phone:830-743-5434
Mailing Address - Fax:
Practice Address - Street 1:8610 N NEW BRAUNFELS AVE STE 405
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6358
Practice Address - Country:US
Practice Address - Phone:210-804-0193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352180164X00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide