Basic Information
| Provider Information | |||||||||
| NPI: | 1932693017 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOOD | ||||||||
| FirstName: | FAITH | ||||||||
| MiddleName: | NEWTON | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN, AGACNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1325 PENNSYLVANIA AVE STE 890 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761042145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172504280 | ||||||||
| FaxNumber: | 8172504281 | ||||||||
| Practice Location | |||||||||
| Address1: | 5323 HARRY HINES BLVD | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753902145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146458800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2018 | ||||||||
| LastUpdateDate: | 05/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084A2900X | AP144583 | TX | N | 2084A2900X | AP139087 | TX | N | 363LA2100X | AP139087 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.