Individual provider · Type 1 NPI

Jennifer Ross Goodwin, CPNP-PC

Nurse Practitioner · Hattiesburg, MS

NPI number 1083246474 Active

Practice location

102 Medical Park
Hattiesburg, MS 39401-9080

Fax (601) 545-1740

Mailing address

415 S 28th Ave
Hattiesburg, MS 39401-7246

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X864754 (MS)
Pediatric Nurse Practitioner 363LP0200X865754 (MS)
Registered Nurse 163W00000X865754 (MS)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1083246474

Jennifer Ross Goodwin, CPNP-PC's National Provider Identifier is 1083246474, issued on Feb 4, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Hattiesburg, MS. The record was last updated on Oct 29, 2026.