Whalio Doctors

NPI 1073009627

Jacqueline Venora Goodgame, LPN

Practitioner Licensed Practical Nurse Southfield, MI

Practice location

Address
4000 Town Ctr, Southfield, MI 48075
Phone
(248) 386-0300
Mailing address
4000 Town Ctr, Southfield, MI 48075-1410

Registered specialties

Licensed Practical Nurse Primary
Nursing Service Providers Taxonomy 164W00000X Licence 4703103750 (MI)

Registry record

NPI
1073009627
Entity type
Individual
Sex (as registered)
Female
NPI issued
6 Jul 2018
Record last updated
16 Aug 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.