Provider Demographics
NPI:1861207656
Name:GOODIN, CAROLYN LEA (DNP, RN)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:LEA
Last Name:GOODIN
Suffix:
Gender:F
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2881 MONTEREY HWY
Mailing Address - Street 2:
Mailing Address - City:RICKMAN
Mailing Address - State:TN
Mailing Address - Zip Code:38580-2056
Mailing Address - Country:US
Mailing Address - Phone:931-349-0081
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4294
Practice Address - Country:US
Practice Address - Phone:931-528-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN253314163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse